Abstract:
BACKGROUND:Predictive models of acute kidney injury after cardiac surgery (CS-AKI) include emergency surgery and patients with hemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS:A prospective, multicenter, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intra-aortic balloon pump. The main outcome measure was CS-AKI defined by the composite of requiring dialysis or doubling baseline creatinine values. RESULTS:Both models showed poor discrimination in elective surgery (Thakar's model, AUC=0.57, 95% CI: 0.50-0.64 and Demirjian's model, AUC=0.64, 95% CI: 0.58-0.71). We generated a new model whose significant independent predictors were: anemia, age, hypertension, obesity, congestive heart failure, previous cardiac surgery and type of surgery. It classifies patients with scores 0-3 as at low risk (<5%), patients with scores 4-7 as at medium risk (up to 15%), and patients with scores >8 as at high risk (>30%) of developing CS-AKI with a statistically significant correlation (P<0.001). Our model reflects acceptable discriminatory ability (AUC=0.72, 95% CI: 0.66-0.78) which is significantly better than Thakar and Demirjian's models (P<0.01). CONCLUSIONS:We developed a new simple predictive model of CS-AKI in elective surgery based on available preoperative information. Our new model is easy to calculate and can be an effective tool for communicating risk to patients and guiding decision-making in the perioperative period. The study requires external validation.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Callejas R,Panadero A,Vives M,Duque P,Echarri G,Monedero P,Renal Dysfunction in Cardiac Surgery Spanish Group (GEDRCC2).doi
10.23736/S0375-9393.18.12257-7subject
Has Abstractpub_date
2019-01-01 00:00:00pages
34-44issue
1eissn
0375-9393issn
1827-1596pii
S0375-9393.18.12257-7journal_volume
85pub_type
杂志文章,多中心研究abstract::Cervical vertebral dislocations and fractures require the complete immobility of the neck until an intervention of stabilization of the spinal cord, by surgery or external means, is performed. Endotracheal intubation, which might represent a harmful operation, can become difficult when the stabilization of the spinal ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
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更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Weaning from mechanical ventilation is often possible in the most of patients, even if sometimes it is very difficult. For example, 25-53% of COPD patients cannot be weaned. The different modalities used do not justify this. The aim of the study was the evaluation of a further weaning trial in tracheotomized ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
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doi:10.23736/S0375-9393.18.12287-5
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pub_type: 杂志文章,meta分析,评审
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abstract::In 1947 John Bonica as new Chief of Anesthesiology at Tacoma General Hospital organized one of the first around-the-clock labor anesthesia services and when became the first chairman of the new Department of Anesthesiology at the University of Washington (1960), caudal anesthesia was the primary technique used for pro...
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pub_type: 传,历史文章,杂志文章
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abstract::Multiple sclerosis is a progressive demyelinating disease which affects large areas of the brain and of the spinal cord. Stressful events, surgical procedures, general anaesthesia and central blocks seem to be responsible for relapses, with worsening of the disease. So, when we scheduled 2 patients with multiple scler...
journal_title:Minerva anestesiologica
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journal_title:Minerva anestesiologica
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pub_type: 临床试验,杂志文章,随机对照试验,评审
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更新日期:1990-11-01 00:00:00
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doi:
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doi:
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journal_title:Minerva anestesiologica
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更新日期:1995-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2012-12-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Minerva anestesiologica
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