Influencing factors and prediction model for acute kidney injury following interventional embolization of intracranial aneurysms under general anesthesia
10.3760/cma.j.cn131073-20241219-01006
- VernacularTitle:全身麻醉下颅内动脉瘤介入栓塞术后AKI的影响因素及预测模型
- Author:
Juan LIU
1
;
Jun LU
1
;
Huihui JIANG
1
;
Jingxing JIN
1
;
Meijuan LIU
1
Author Information
1. 南京医科大学附属脑科医院麻醉科，南京 210029
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
Intracranial aneurysm;
Embolization, therapeutic;
Risk factors;
Prediction model
- From:
Chinese Journal of Anesthesiology
2025;45(10):1259-1263
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the influencing factors for acute kidney injury (AKI) in patients undergoing interventional embolization of intracranial aneurysms under general anesthesia and develop a predictive model.Methods:In this retrospective study, the clinical data from patients who underwent elective interventional embolization of intracranial aneurysms at Hospital Affiliated to Nanjing Medical University from January 2019 to December 2023 were collected. All the patients were divided into AKI group and non-AKI group based on whether AKI occurred postoperatively. The general data, preoperative laboratory parameters, and intraoperative parameters of the patients were obtained through the electronic medical record system and operation-anesthesia management system. The variables screened using LASSO regression were included in the multivariate logistic regression analysis to identify the risk factors for AKI following embolization of cerebrovascular aneurysms. Based on the results, a predictive model was established and evaluated.Results:A total of 428 patients were collected, with 73 in AKI group and 355 in non-AKI group. LASSO regression for variable selection and multivariate logistic regression analysis showed that serum creatinine concentration, duration of surgery and age were independent risk factors, and the glomerular filtration rate and hemoglobin concentration were protective factors for AKI after interventional embolization of intracranial aneurysms ( P<0.05). The area under the receiver operating characteristic curve of the prediction model was 0.860 (95% confidence interval 0.815 to 0.905), with a sensitivity of 0.880 and a specificity of 0.718. The calibration curve showed a mean absolute error of 0.014. The Hosmer-Lemeshow goodness-of-fit test indicated that there was no statistically significant difference between the predicted and observed values of the model ( χ2=3.29, P=0.915). The clinical decision curve demonstrated that the net benefit rate for patients was higher when the threshold probability ranged from 0 to 0.83. Conclusions:The glomerular filtration rate, serum creatinine concentration, hemoglobin concentration, duration of surgery and age are influencing factors for AKI following interventional embolization of intracranial aneurysms, and the prediction model established based on these factors demonstrates good predictive performance.
