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. 2019 Nov 21;20(1):419.
doi: 10.1186/s12882-019-1610-9.

Acute kidney injury in non-critical care setting: elaboration and validation of an in-hospital death prognosis score

Jamal Bamoulid  1   2   3   4 , Hélène Philippot  5 , Amir Kazory  6 , Maria Yannaraki  7 , Thomas Crepin  7   8   9   10 , Bérengère Vivet  7 , Nadège Devillard  7 , Caroline Roubiou  7 , Catherine Bresson-Vautrin  7 , Jean-Marc Chalopin  7   8   9   10 , Cécile Courivaud  7   8   9   10 , Didier Ducloux  7   8   9   10
Affiliations

Acute kidney injury in non-critical care setting: elaboration and validation of an in-hospital death prognosis score

Jamal Bamoulid et al. BMC Nephrol. .

Abstract

Background: Acute kidney injury (AKI) is still characterized by a high mortality rate. While most patients with AKI are admitted in conventional medical units, current available data are still obtained from studies designed for patients admitted in intensive care units (ICU). Our study aimed to elaborate and validate an in-hospital death prognosis score for AKI admitted in conventional medical care units.

Methods: We included two prospective cohorts of consecutive patients with AKI admitted between 2001 and 2004 (elaboration cohort (EC)) and between 2010 and 2014 (validation cohort (VC)). We developed a scoring system from clinical and biological parameters recorded at admission from the EC to predict in-hospital mortality. This score was then tested for validation in the VC.

Results: Three-hundred and twenty-three and 534 patients were included in the EC and VC cohorts, respectively. The proportion of in-hospital death were 15.5% (EC) and 8.9% (VC), mainly due to sepsis. The parameters independently associated with the in-hospital death in the EC were Glasgow score, oxygen requirement, fluid overload, blood diastolic pressure, multiple myeloma and prothrombin time. The in-hospital death prognosis score AUC was 0.845 +/- 0.297 (p < 0.001) after validation in the VC.

Conclusions: Our in-hospital death prognosis score is the first to be prospectively developed and validated for AKI admitted in a conventional medical care unit. Based on current parameters, easily collected at time of admission, this score could be a useful tool for physicians and nephrologists to determine the in-hospital death prognosis of this AKI population.

Keywords: Cute kidney injury; Iatrogenesis; In-hospital death; Prognosis score; Score validation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
ROC curve of the in-hospital death prognosis score P2(id) applied to the elaboration cohort (EC): AUC 0.872 (p < 0.0001)
Fig. 2
Fig. 2
ROC curve of the in-hospital death prognosis score P2(id) applied to the validation cohort (VC): AUC 0.845 (p < 0.0001)
See this image and copyright information in PMC

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