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Development and validation of an interpretable clinical score for early identification of acute kidney injury at the emergency department.
Ang, Yukai; Li, Siqi; Ong, Marcus Eng Hock; Xie, Feng; Teo, Su Hooi; Choong, Lina; Koniman, Riece; Chakraborty, Bibhas; Ho, Andrew Fu Wah; Liu, Nan.
Afiliação
  • Ang Y; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Li S; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Ong MEH; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Xie F; Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.
  • Teo SH; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Choong L; Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
  • Koniman R; Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
  • Chakraborty B; Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
  • Ho AFW; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Liu N; Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA.
Sci Rep ; 12(1): 7111, 2022 05 02.
Article em En | MEDLINE | ID: mdl-35501411
Acute kidney injury (AKI) in hospitalised patients is a common syndrome associated with poorer patient outcomes. Clinical risk scores can be used for the early identification of patients at risk of AKI. We conducted a retrospective study using electronic health records of Singapore General Hospital emergency department patients who were admitted from 2008 to 2016. The primary outcome was inpatient AKI of any stage within 7 days of admission based on the Kidney Disease Improving Global Outcome (KDIGO) 2012 guidelines. A machine learning-based framework AutoScore was used to generate clinical scores from the study sample which was randomly divided into training, validation and testing cohorts. Model performance was evaluated using area under the curve (AUC). Among the 119,468 admissions, 10,693 (9.0%) developed AKI. 8491 were stage 1 (79.4%), 906 stage 2 (8.5%) and 1296 stage 3 (12.1%). The AKI Risk Score (AKI-RiSc) was a summation of the integer scores of 6 variables: serum creatinine, serum bicarbonate, pulse, systolic blood pressure, diastolic blood pressure, and age. AUC of AKI-RiSc was 0.730 (95% CI 0.714-0.747), outperforming an existing AKI Prediction Score model which achieved AUC of 0.665 (95% CI 0.646-0.679) on the testing cohort. At a cut-off of 4 points, AKI-RiSc had a sensitivity of 82.6% and specificity of 46.7%. AKI-RiSc is a simple clinical score that can be easily implemented on the ground for early identification of AKI and potentially be applied in international settings.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Injúria Renal Aguda Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: Sci Rep Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Injúria Renal Aguda Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: Sci Rep Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Singapura