#2593 Comparison of four predictive scoring models as assessment tools for cardiac surgery-associated acute kidney injury in post cardiac surgery patients

Abstract

Abstract Background and Aims Cardiac surgery-associated acute kidney injury (CSA-AKI) is a predominant contributor to hospital-acquired AKI in ICU following sepsis. Despite a rising frequency of CSA-AKI, currently examined predictive models have not consistently delivered accurate stratification. Utilizing risk stratification systems offers clinicians the opportunity to identify patients at high risk, extend monitoring intervals, facilitate timely referral to nephrology services, and promptly initiate effective preventive and therapeutic interventions known to enhance renal function. This study seeks to identify the most effective model by comparing four established predictive scoring systems. The objective of this single-center retrospective, cross sectional study is to compare the clinical values of the Cleveland Clinical Score, Mehta Score, Simplified Renal Index and Acute Kidney Injury following Cardiac Surgery (AKICS) Score in predicting CS-AKI among patients who underwent cardiac surgery. Method A comprehensive examination of medical records was conducted for all individuals who underwent open-heart surgery between January 2010 and January 2019. Those patients who had CSA-AKI were subsequently identified. These identified individuals underwent assessment using the four predictive scoring models, leading to their categorization into high or low-risk groups for AKI development. Binary logistics regression was then used to describe the association between CSA-AKI development and the four scoring methods as predictors. Results Among the 114 cases of open-heart surgeries, 86 were eligible for inclusion in the study. Half of the patients, specifically 43 individuals (50%), developed CS-AKI, with 5 requiring renal replacement therapy. Among the four scoring methods evaluated, only the Mehta score (95% CI, p 0.019) and AKICS score (95% CI, p 0.011) demonstrated statistical significance in predicting CS-AKI. The odds ratios for both the Mehta Score (1.10) and AKICS Score (1.19) exceeded 1, suggesting that an increase in either score is associated with a higher likelihood of AKI occurrence. Conversely, the Cleveland Clinical Score (p 0.106) and Simplified Renal Index (p 0.399) were not found to be predictive. Conclusion In this single-center study, both the Mehta score and the AKICS scoring system demonstrated predictability for AKI after open-heart surgery. However, the Cleveland Clinical Scoring and Simplified Renal Index did not exhibit predictive capability in this context.