Development and Validation of a Novel Nomogram for Predicting Perioperative Acute Kidney Injury Following Isolated Off-Pump Coronary Artery Bypass Grafting Surgery.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Surgery Forum Pub Date : 2023-12-27 DOI:10.59958/hsf.6939
Shoulei Chen, Cheng Luo, Chen Fang, Yugui Li, Xiongwei Cai, Guoxing Ling, Haitao Song, Sida Fan, Linsheng Mi, Sai Zheng, Baoshi Zheng
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Abstract

Background: The aim of this work was to create a novel model for predicting acute kidney injury (AKI) after off-pump coronary artery bypass graft (OPCABG).

Methods: The individuals who underwent OPCABG were randomly separated into a derivation group and a validation group, at a 7:3 ratio. The primary outcome was AKI under the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. To optimize feature selection and construct a nomogram, both least absolute shrinkage and selection operator regression (LASSO) and logistic regression analysis were utilized. The nomogram was assessed in various ways: with the C-index, calibration curve, decision curve analysis (DCA), and clinical impact curve analysis (CICA).

Results: The use of an intra-aortic balloon pump (IABP), systolic blood pressure, smoking and baseline serum creatinine were identified as independent impact factors. The C-index of the nomogram was 0.733 (95% confidence interval (CI) = 0.669-0.791) and 0.786 (95% CI = 0.693-0.878) in the training and validation groups, respectively. The area under the curve (AUC) of the internal validation was 0.715 using bootstrapping with 1000 replicates. The calibration plot revealed that the predicted outcomes aligned well with the observations. DCA and CICA suggested that the model had clinical benefit.

Conclusion: The nomogram that relied on clinical characteristics proved to be a dependable instrument to predict AKI after OPCABG. This model is conveniently applicable in clinical settings and will be a valuable resource for assessing timely medical measures to mitigate risk.

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开发并验证用于预测孤立的非泵冠状动脉旁路移植手术后围手术期急性肾损伤的新提名图。
背景:这项研究的目的是建立一个新模型,用于预测体外循环冠状动脉搭桥术(OPCABG)后的急性肾损伤(AKI):这项研究的目的是建立一个新模型,用于预测非体外循环冠状动脉搭桥术(OPCABG)后的急性肾损伤(AKI):方法:将接受 OPCABG 手术的患者按 7:3 的比例随机分为推导组和验证组。主要结果是肾脏疾病:改善全球预后(KDIGO)标准下的 AKI。为了优化特征选择和构建提名图,采用了最小绝对收缩和选择算子回归(LASSO)和逻辑回归分析。对提名图进行了多种评估:C 指数、校准曲线、决策曲线分析(DCA)和临床影响曲线分析(CICA):结果:使用主动脉内球囊反搏泵(IABP)、收缩压、吸烟和基线血清肌酐被确定为独立的影响因素。训练组和验证组的提名图 C 指数分别为 0.733(95% 置信区间 (CI) = 0.669-0.791)和 0.786(95% CI = 0.693-0.878)。使用 1000 次重复的引导法,内部验证的曲线下面积(AUC)为 0.715。校准图显示,预测结果与观测结果非常吻合。DCA和CICA表明该模型具有临床益处:依赖临床特征的提名图被证明是预测 OPCABG 术后 AKI 的可靠工具。该模型可方便地应用于临床环境,并将成为评估及时采取医疗措施以降低风险的宝贵资源。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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