P0611COMPARISON OF FOUR PREDICTIVE SCORING MODELS AS ASSESSMENT TOOLS FOR CARDIAC SURGERY ASSOCIATED ACUTE KIDNEY INJURY IN POST CARDIAC SURGERY PATIENTS IN A PHILIPPINE LOCAL TERTIARY HOSPITAL FROM JANUARY 2010- JANUARY 2019
Authors: Iway Cathleen 
Published: June 2020

Background and Aims

Cardiac surgery associated acute kidney injury is the most common cause of hospital acquired acute kidney injury in the intensive unit after sepsis. In Asia, incidence ranges from 17 to 49%, with 2 to 6 % of patients requiring dialysis after developing acute kidney injury. Its occurrence has shown increased morbidity, length of hospital stay, and utilization of resources which affect overall outcome of the patients. These patients face a combination of renal stressors and some patient populations deserve special consideration with regards to the risk factors identified preoperatively. Therefore, early prediction of cardiac surgery associated acute kidney injury is optimal.

This study aims to compare the clinical values of the Cleveland Clinical Score, Mehta Score, Simplified Renal Index and Acute Kidney Injury following Cardiac Surgery Score in predicting cardiac surgery-associated acute kidney injury among patients who underwent cardiac surgery in Perpetual Succour Hospital, Cebu City from January 2010- January 2019.

Method

A chart review was done to all patients who underwent open heart surgery during the time period of January 2010 to January 2019. The patients who developed cardiac surgery associated- acute kidney injuries were identified using the four different predictive scoring methods. Binary logistic regression was used to describe the relationship between the development of CSA- AKI and the four scoring methods as its predictors. Confidence interval is set at 95%, comparison significant at &lt;0.05, hypotheses tested at 0.05 level of significance. Therefore, if the p-value is less than or equal to the significance level, it can be concluded that there is a statistically significant association between the response variable and the predictor.

Results

There were a total of 114 cases of open heart surgeries. A sample size population of 86 were reviewed, and was divided into 2 groups, there were 43 patients (50%) who developed cardiac surgery associated acute kidney injury and 43 patients (50%) who did not develop CSA- AKI. Patients with recorded variables useful in all scoring systems were included. The p- values for the Cleveland Clinical Score and Simplified Renal Index are greater than the significance level. With the p- values less than the significance level, there is statistically significant association between the Mehta (p value 0.019) and AKICS score (p value 0.011) and the development of CSA- AKI. The odds ratios for both Mehta Score (1.10) and AKICS Score (1.19) are also greater than 1, indicating that AKI is more likely to occur if the Mehta score or the AKICS Score increases.

Conclusion

In our single- center study, acute kidney injury was more likely if the scores for both Mehta and AKICS scoring system methods increase. This supports that either Mehta or the AKICS scoring systems are useful methods that can be employed to predict cardiac surgery-associated acute kidney injury among patients who underwent cardiac surgery.