Risk Prediction for Acute Kidney Injury in Patients Hospitalized With COVID-19.
Risk Prediction for Acute Kidney Injury in Patients Hospitalized With COVID-19.
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DOI：
10.1016/j.xkme.2022.100463
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发表时间：
2022-06
期刊：
影响因子：
3.9
通讯作者：
Hedayati SS
中科院分区：
文献类型：
--
作者：
McAdams MC;Xu P;Saleh SN;Li M;Ostrosky-Frid M;Gregg LP;Willett DL;Velasco F;Lehmann CU;Hedayati SS
急性肾损伤（阿基）在因COVID-19住院的患者中很常见，但缺乏经过验证的阿基预测模型。我们的目标是开发2019年冠状病毒病住院患者阿基的最佳预测模型，并随着疫苗和Delta变体的出现评估其随时间的表现。纵向队列研究。2020年3月1日至2021年8月20日期间，德克萨斯州19家医院的严重急性呼吸综合征冠状病毒2聚合酶链反应结果呈阳性的住院患者。合并症、基线实验室数据、炎症生物标志物。根据KDIGO（肾脏疾病：改善全球结局）肌酐标准定义的阿基。在一个开发队列中构建了三个阿基嵌套模型，并在2个超时队列中进行了验证。在队列中比较模型区分和校准措施，以评估随时间推移的性能。在10，034例患者中，分别有5，676例、2，917例和1，441例患者在开发、验证1和验证2队列中，其中分别有776例（13.7%）、368例（12.6%）和179例（12.4%）发生阿基（P = 0.26）。验证队列2中的患者共病较少，并且比开发队列或验证队列1中的患者更年轻（平均年龄分别为54 ± 16.8岁vs 61.4 ± 17.5岁和61.7 ± 17.3岁，P < 0.001）。验证队列2的中位高敏C反应蛋白水平（81.7 mg/L）高于开发队列（74.5 mg/L; P < 0.01），中位铁蛋白水平（696 ng/mL）高于开发队列（444 ng/mL）和验证队列1（496 ng/mL; P < 0.001）。最终模型增加了高敏C反应蛋白、铁蛋白和D-二聚体水平，曲线下面积为0.781（95% CI，0.763-0.799）。与发育队列相比，按曲线下面积区分（验证1：0.785 [0.760-0.810]，P = 0.79，验证2：0.754 [0.716-0.795]，P = 0.53）和通过估计校准指数进行校准（验证1：0.116 [0.041-0.281]，P = 0.11，验证2：0.081 [0.045-0.295]，P = 0.11）显示随时间推移性能稳定。潜在的计费和编码偏差。我们开发并外部验证了一个模型，以准确预测2019年冠状病毒病患者的阿基。该模型的性能经受住了实践模式和病毒变体的变化。
Acute kidney injury (AKI) is common in patients hospitalized with COVID-19, but validated, predictive models for AKI are lacking. We aimed to develop the best predictive model for AKI in hospitalized patients with coronavirus disease 2019 and assess its performance over time with the emergence of vaccines and the Delta variant. Longitudinal cohort study. Hospitalized patients with a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result between March 1, 2020, and August 20, 2021 at 19 hospitals in Texas. Comorbid conditions, baseline laboratory data, inflammatory biomarkers. AKI defined by KDIGO (Kidney Disease: Improving Global Outcomes) creatinine criteria. Three nested models for AKI were built in a development cohort and validated in 2 out-of-time cohorts. Model discrimination and calibration measures were compared among cohorts to assess performance over time. Of 10,034 patients, 5,676, 2,917, and 1,441 were in the development, validation 1, and validation 2 cohorts, respectively, of whom 776 (13.7%), 368 (12.6%), and 179 (12.4%) developed AKI, respectively (P = 0.26). Patients in the validation cohort 2 had fewer comorbid conditions and were younger than those in the development cohort or validation cohort 1 (mean age, 54 ± 16.8 years vs 61.4 ± 17.5 and 61.7 ± 17.3 years, respectively, P < 0.001). The validation cohort 2 had higher median high-sensitivity C-reactive protein level (81.7 mg/L) versus the development cohort (74.5 mg/L; P < 0.01) and higher median ferritin level (696 ng/mL) versus both the development cohort (444 ng/mL) and validation cohort 1 (496 ng/mL; P < 0.001). The final model, which added high-sensitivity C-reactive protein, ferritin, and D-dimer levels, had an area under the curve of 0.781 (95% CI, 0.763-0.799). Compared with the development cohort, discrimination by area under the curve (validation 1: 0.785 [0.760-0.810], P = 0.79, and validation 2: 0.754 [0.716-0.795], P = 0.53) and calibration by estimated calibration index (validation 1: 0.116 [0.041-0.281], P = 0.11, and validation 2: 0.081 [0.045-0.295], P = 0.11) showed stable performance over time. Potential billing and coding bias. We developed and externally validated a model to accurately predict AKI in patients with coronavirus disease 2019. The performance of the model withstood changes in practice patterns and virus variants.
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DOI：
10.1056/nejmoa2022926
发表时间：
2020-11-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
RECOVERY Collaborative Group;Horby P;Mafham M;Linsell L;Bell JL;Staplin N;Emberson JR;Wiselka M;Ustianowski A;Elmahi E;Prudon B;Whitehouse T;Felton T;Williams J;Faccenda J;Underwood J;Baillie JK;Chappell LC;Faust SN;Jaki T;Jeffery K;Lim WS;Montgomery A;Rowan K;Tarning J;Watson JA;White NJ;Juszczak E;Haynes R;Landray MJ
通讯作者：
Landray MJ
DOI：
10.1053/j.ajkd.2020.12.007
发表时间：
2021-04
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Moledina DG;Simonov M;Yamamoto Y;Alausa J;Arora T;Biswas A;Cantley LG;Ghazi L;Greenberg JH;Hinchcliff M;Huang C;Mansour SG;Martin M;Peixoto A;Schulz W;Subair L;Testani JM;Ugwuowo U;Young P;Wilson FP
通讯作者：
Wilson FP
DOI：
10.15585/mmwr.mm7038e3
发表时间：
2021-09-24
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Hagan LM;McCormick DW;Lee C;Sleweon S;Nicolae L;Dixon T;Banta R;Ogle I;Young C;Dusseau C;Salmonson S;Ogden C;Godwin E;Ballom T;Ross T;Browne H;Harcourt JL;Tamin A;Thornburg NJ;Kirking HL;Salvatore PP;Tate JE
通讯作者：
Tate JE
影响因子：
13.6
作者：
Gupta, Shruti;Coca, Steven G.;Leaf, David E.
通讯作者：
Leaf, David E.
影响因子：
13.6
作者：
Fisher, Molly;Neugarten, Joel;Golestaneh, Ladan
通讯作者：
Golestaneh, Ladan