Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Jun 27;6(6):e010176.
doi: 10.1136/bmjopen-2015-010176.

Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study

Shao-Wei Chen  1 , Chih-Hsiang Chang  2 , Pei-Chun Fan  2 , Yung-Chang Chen  3 , Pao-Hsien Chu  4 , Tien-Hsing Chen  4 , Victor Chien-Chia Wu  4 , Su-Wei Chang  5 , Pyng-Jing Lin  6 , Feng-Chun Tsai  6
Affiliations
Comparative Study

Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study

Shao-Wei Chen et al. BMJ Open. .

Abstract

Objectives: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with short-term and long-term adverse outcomes. The European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, the Society of Thoracic Surgeons (STS) score and Age, Creatinine and Ejection Fraction (ACEF) score, have been widely used for predicting the operative risk of cardiac surgery. The aim of this study is to investigate the discriminant ability among current available models in predicting postoperative AKI.

Methods: From January 2010 to December 2012, 353 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes and scores of prognostic models were collected. The primary outcome was postoperative AKI, defined based on the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline for AKI, in 2012.

Results: 102 patients (28.9%) developed postoperative AKI. For AKI prediction, EuroSCORE II, STS score and ACEF score were all good tools for stage-3 AKI. The ACEF score was shown to have satisfied discriminant ability to predict postoperative AKI with area under a receiver operating characteristic curve: 0.781±0.027, (95% CI 0.729 to 0.834, p value <0.001). Multivariate logistic analysis identified that lower ejection fraction and higher serum creatinine were independent risk factors for AKI.

Conclusions: The simple and extremely user-friendly ACEF score can accurately identify the risk of postoperative AKI and has shown satisfactory discriminant ability when compared with other systems. The ACEF score might be the easiest tool for predicting postoperative AKI.

Keywords: Coronary artery bypass grafting; acute kidney injury; coronary artery disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Quintile calibration plots of STS-renal failure for expected AKI and observed AKI. AKI, acute kidney injury; STS, Society of Thoracic Surgeons.
Figure 2
Figure 2
Short-term survival according to non-AKI and AKI groups. AKI, acute kidney injury.
See this image and copyright information in PMC

References

    1. Oezkur M, Wagner M, Weismann D et al. Chronic hyperglycemia is associated with acute kidney injury in patients undergoing CABG surgery—a cohort study. BMC Cardiovasc Disord 2015;15:41 10.1186/s12872-015-0028-y - DOI - PMC - PubMed
    1. Gallagher S, Jones DA, Lovell MJ et al. The impact of acute kidney injury on midterm outcomes after coronary artery bypass graft surgery: a matched propensity score analysis. J Thorac Cardiovasc Surg 2014;147:989–95. 10.1016/j.jtcvs.2013.03.016 - DOI - PubMed
    1. Ryden L, Ahnve S, Bell M et al. Acute kidney injury after coronary artery bypass grafting and long-term risk of myocardial infarction and death. Int J Cardiol 2014;172:190–5. 10.1016/j.ijcard.2014.01.013 - DOI - PubMed
    1. Rosner MH, Okusa MD. Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol 2006;1:19–32. 10.2215/CJN.00240605 - DOI - PubMed
    1. Chen YC, Tsai FC, Chang CH et al. Prognosis of patients on extracorporeal membrane oxygenation: the impact of acute kidney injury on mortality. Ann Thorac Surg 2011;91:137–42. 10.1016/j.athoracsur.2010.08.063 - DOI - PubMed

MeSH terms

LinkOut - more resources