Risk factors for acute kidney injury after lumbar surgery in elderly patients and development of a prediction model
10.3760/cma.j.cn131073.20220318.00505
- VernacularTitle:老年患者腰椎术后急性肾损伤的危险因素及其预测模型
- Author:
Qiuchong CHEN
1
;
Yixue ZHANG
;
Mengjun ZHANG
;
Ziying LI
;
Jindong LIU
Author Information
1. 徐州医科大学江苏省麻醉学重点实验室，徐州 221004
- Keywords:
Aged;
Lumbar vertebrae;
Acute kidney injury;
Risk factors;
Forecasting
- From:
Chinese Journal of Anesthesiology
2022;42(5):534-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for acute kidney injury (AKI) after lumbar surgery in elderly patients and develop a score prediction model.Methods:The elderly patients who underwent lumbar surgery were retrospectively analyzed.The patients were divided into AKI group and non-AKI group according to the diagnostic criteria in Kidney Disease: Improving Global Outcomes.Demographic data, history of underlying diseases, perioperative general status and related research laboratory tests were collected.Factors with statistically significant differences between groups were included in the logistic regression model.Risk factors were identified and the weighted score regression prediction model was developed.The receiver operating characteristic curve was drawn, and the model was evaluated.Results:AKI occurred in 87 patients (11.9%) after operation.Logistic regression results showed that increasing age, hypertension, anemia, hypoproteinemia, diabetes mellitus, duration of intraoperative low mean arterial pressure and blood transfusion were independent risk factors for AKI in elderly patients after lumbar surgery.The area under the receiver operating characteristic curve and 95% confidence interval were 0.909 (0.870-0.947), the sensitivity was 79.36%, the specificity was 92.74%, and the Youdon index was 0.719.The line chart prediction model was developed.The prediction analysis model was verified by Hosmer-Lemshow test, P=0.413, and the C-index visualized line chart prediction model was 0.908. Conclusions:Increasing age, hypertension, hypoproteinemia, diabetes mellitus, anemia, duration of intraoperative low mean arterial pressure and blood transfusion are independent risk factors for AKI after lumbar surgery in elderly patients.The risk prediction model developed can effectively predict the occurrence of AKI after lumbar surgery in elderly patients.
