The Applicability of an Acute Kidney Injury Risk Index for Patients Undergoing General Surgery in a Tertiary University Setting
Michael Angelo P. Doromal, Stephanie C. Andres
Oct 2019 DOI 10.35460/2546-1621.2018-0032 Access
Acute kidney injury (AKI) in the perioperative period has serious implications, being with more complicated hospital course with associated cost implications. Identification of risk factors, close monitoring of renal function and early adoption of both preventive measures and treatments remain important considerations for those taking care of perioperative patients who are likely to develop AKI
The Aim of this study is to determine if the AKI risk index by Kheterpal 2009, is able able to identify those patient's at risk for AKI undergoing non-Cardiac Surgery. This is a cross-sectional study, wherein a total of 145 patients charts where reviewed from September 2016 to May 2017. About 59 patients had AKI and 86 patients did not develop AKI. The most common operations done are hindgut, urologic and musculoskeletal surgeries.
The baseline characteristics of patients included in the study show that those in the AKI group are significantly older, with a mean age 66.2 vs. 60.2 years (p-value-0.017); renal insufficiency, emergency surgery, ascites, active Congestive Heart Failure, hypertension, lower estimated glomerular filtration rate(eGFR), recent Myocardial infarction(MI), and Peripheral arterial occlusive diease(PAOD). Whereas there is no significant difference between the groups in terms of male gender, intra-peritoneal surgery, type II diabetic, previous cardiac intervention and Cerebrovascular accident(CVA).
A ROC curve was then formulated and the area under the curve(AUC) determined to be.0.799 (95% CI: 0.729 – 0.870). Hence the AKI risk index by Kheterphal is acceptable predictor of AKI among non-cardiac surgery patients. Hence, It is recommended that this risk scoring be used at the University of Santo Tomas Hospital. It has a sensitivity of 57.6% and 86% sensitivity if with more than 5 risk factors are identified.
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