The applicability of an acute kidney injury risk index for patients undergoing general surgery in a tertiary university setting
10.35460/2546-1621.2018-0032
- Author:
Michael Angelo P DOROMAL
1
;
Stephanie C ANDRES
1
Author Information
1. Section of Nephrology, Department of Medicine, University of Santo Tomas Hospital
- Publication Type:Other Types
- MeSH:
Kidney;
Patients
- From:
Journal of Medicine University of Santo Tomas
2019;3(2):354-361
- CountryPhilippines
- Language:English
-
Abstract:
Acute kidney injury (AKI) in the perioperative period
has serious implications, being with a more complicated hospital course and associated cost implications. Identii cation of risk factors, close monitoring
of renal function, and early adoption of both preventive measures and treatments remain important
considerations for those taking care of perioperative
patients who are likely to develop AKI.
The aim of this study is to determine if the AKI
risk index by Kheterpal [4] is able to identify those
patients at risk for AKI undergoing non-cardiac surgery. This is a cross-sectional study, wherein a total
of 145 patients’ charts were reviewed from September 2016 to May 2017. About 59 patients had
AKI and 86 patients did not develop AKI. The most
common operations done are hindgut, urologic, and
musculoskeletal surgeries.
The baseline characteristics of patients included in
the study show that those in the AKI group are signii -
cantly older with a mean age of 66.2 vs. 60.2 years (p-value 0.017); renal insufi ciency, emergency surgery, ascites, active congestive heart failure, hypertension, lower estimated glomerular i ltration rate
(eGFR), recent myocardial infarction (MI), and peripheral arterial occlusive disease (PAOD). Whereas
there is no signii cant difference between the groups
in terms of the male gender, intraperitoneal surgery,
type II diabetes, previous cardiac intervention, and
cerebrovascular accident (CVA).
A ROC curve was then formulated and the area
under the curve (AUC) determined to be 0.799
(95% CI: 0.729–0.870). Hence, the AKI risk index by Kheterpal is an acceptable predictor of AKI
among non-cardiac surgery patients. Therefore, it is
recommended that this risk scoring be used at the
University of Santo Tomas Hospital. It has a sensitivity of 57.6% and 86% sensitivity with more than i ve
risk factors identii ed.
- Full text:1 JMUST 017.pdf
