TY - JOUR
T1 - Predicting acute kidney injury after cardiac surgery
T2 - A systematic review
AU - Huen, Sarah
AU - Parikh, Chirag R.
N1 - Funding Information:
Special thanks to Umo Inayam for her assistance in data acquisition and to Mark Gentry for his assistance in the development of the literature search strategy. Dr Parikh was supported by the National Institutes of Health (NIH) grant R01 HL-085757 . Dr Huen was supported by NIH grant T32-DK007276–32 .
PY - 2012/1
Y1 - 2012/1
N2 - Acute kidney injury (AKI) after cardiac surgery confers a significant increased risk of death. Several risk models have been developed to predict postoperative kidney failure after cardiac surgery. This systematic review evaluated the available risk models for AKI after cardiac surgery. Literature searches were performed in the Web of Science/Knowledge, Scopus, and MEDLINE databases for articles reporting the primary development of a risk model and articles reporting validation of existing risk models for AKI after cardiac surgery. Data on model variables, internal or external validation (or both), measures of discrimination, and measures of calibration were extracted. The systematic review included 7 articles with a primary development of a prediction score for AKI after cardiac surgery and 8 articles with external validation of established models. The models for AKI requiring dialysis are the most robust and externally validated. Among the prediction rules for AKI requiring dialysis after cardiac surgery, the Cleveland Clinic model has been the most widely tested thus far and has shown high discrimination in most of the tested populations. A validated score to predict AKI not requiring dialysis is lacking. Further studies are required to develop risk models to predict milder AKI not requiring dialysis after cardiac surgery. Standardizing risk factor and AKI definitions will facilitate the development and validation of risk models predicting AKI.
AB - Acute kidney injury (AKI) after cardiac surgery confers a significant increased risk of death. Several risk models have been developed to predict postoperative kidney failure after cardiac surgery. This systematic review evaluated the available risk models for AKI after cardiac surgery. Literature searches were performed in the Web of Science/Knowledge, Scopus, and MEDLINE databases for articles reporting the primary development of a risk model and articles reporting validation of existing risk models for AKI after cardiac surgery. Data on model variables, internal or external validation (or both), measures of discrimination, and measures of calibration were extracted. The systematic review included 7 articles with a primary development of a prediction score for AKI after cardiac surgery and 8 articles with external validation of established models. The models for AKI requiring dialysis are the most robust and externally validated. Among the prediction rules for AKI requiring dialysis after cardiac surgery, the Cleveland Clinic model has been the most widely tested thus far and has shown high discrimination in most of the tested populations. A validated score to predict AKI not requiring dialysis is lacking. Further studies are required to develop risk models to predict milder AKI not requiring dialysis after cardiac surgery. Standardizing risk factor and AKI definitions will facilitate the development and validation of risk models predicting AKI.
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U2 - 10.1016/j.athoracsur.2011.09.010
DO - 10.1016/j.athoracsur.2011.09.010
M3 - Review article
C2 - 22186469
AN - SCOPUS:84055222724
SN - 0003-4975
VL - 93
SP - 337
EP - 347
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -