A web-based tool to predict acute kidney injury in patients with ST-elevation myocardial infarction: Development, internal validation and comparison.
A web-based tool to predict acute kidney injury in patients with ST-elevation myocardial infarction: Development, internal validation and comparison.
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DOI：
10.1371/journal.pone.0181658
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Reed GL
中科院分区：
文献类型：
--
作者：
Zambetti BR;Thomas F;Hwang I;Brown AC;Chumpia M;Ellis RT;Naik D;Khouzam RN;Ibebuogu UN;Reed GL
在ST段抬高心肌梗死(STEMI)中，急性肾损伤(AKI)可能会增加后续的发病率和死亡率。尽管如此，仍然很难预测这些患者的AKI风险。我们试图1)确定AKI的频率和临床结果，2)开发、验证和比较基于网络的AKI预测工具。在一组不同种族的连续1144例STEMI患者中，1期或以上AKI的发生率为12.9%，严重(2-3期)的发生率为2.9%。AKI与死亡率(5.7倍，未调整)和住院时间(2.5倍)增加有关。AKI与收缩功能障碍、左心室舒张末压力升高、低血压和主动脉内球囊反搏有关。推导了一种计算算法(UT-AKI)，并进行了内部验证。与其他已发表的指数相比，它对AKI(曲线下面积0.76)显示出更高的灵敏度和更好的整体预测。UT-AKI评分越高，AKI越严重，住院时间越长，住院死亡率越高。在一大群不同种族的STEMI患者中，1期或以上急性心肌梗死相对常见，并与显著的发病率和死亡率相关。开发了一个网络可访问、内部验证的工具，提高了预测AKI的总体价值。通过识别风险增加的患者，该工具可以帮助医生定制STEMI后的术后诊断和治疗策略，以减少急性心肌梗死及其相关的发病率和死亡率。
In ST-elevation myocardial infarction (STEMI), acute kidney injury (AKI) may increase subsequent morbidity and mortality. Still, it remains difficult to predict AKI risk in these patients. We sought to 1) determine the frequency and clinical outcomes of AKI and, 2) develop, validate and compare a web-based tool for predicting AKI. In a racially diverse series of 1144 consecutive STEMI patients, Stage 1 or greater AKI occurred in 12.9% and was severe (Stage 2–3) in 2.9%. AKI was associated with increased mortality (5.7-fold, unadjusted) and hospital stay (2.5-fold). AKI was associated with systolic dysfunction, increased left ventricular end-diastolic pressures, hypotension and intra-aortic balloon counterpulsation. A computational algorithm (UT-AKI) was derived and internally validated. It showed higher sensitivity and improved overall prediction for AKI (area under the curve 0.76) vs. other published indices. Higher UT-AKI scores were associated with more severe AKI, longer hospital stay and greater hospital mortality. In a large, racially diverse cohort of STEMI patients, Stage 1 or greater AKI was relatively common and was associated with significant morbidity and mortality. A web-accessible, internally validated tool was developed with improved overall value for predicting AKI. By identifying patients at increased risk, this tool may help physicians tailor post-procedural diagnostic and therapeutic strategies after STEMI to reduce AKI and its associated morbidity and mortality.
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影响因子：
39.2
作者：
Mangano, CM;Diamondstone, LS;Mangano, DT
通讯作者：
Mangano, DT
影响因子：
168.9
作者：
Lozano, Rafael;Naghavi, Mohsen;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
影响因子：
11.3
作者：
Tsai, Thomas T.;Patel, Uptal D.;Chang, Tara I.;Kennedy, Kevin F.;Masoudi, Frederick A.;Matheny, Michael E.;Kosiborod, Mikhail;Amin, Amit P.;Messenger, John C.;Rumsfeld, John S.;Spertus, John A.
通讯作者：
Spertus, John A.
影响因子：
37.8
作者：
Ranucci, Marco;Castelvecchio, Serenella;Pelissero, Gabriele
通讯作者：
Pelissero, Gabriele
DOI：
10.1186/cc2872
发表时间：
2004-08
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bellomo R;Ronco C;Kellum JA;Mehta RL;Palevsky P;Acute Dialysis Quality Initiative workgroup
通讯作者：
Acute Dialysis Quality Initiative workgroup