Construction and evaluation of a nomogram to predict acute kidney injury in patients undergoing Cox Maze Ⅲ procedure combined with cardiac valve surgery
Construction and evaluation of a nomogram to predict acute kidney injury in patients undergoing Cox Maze Ⅲ procedure combined with cardiac valve surgery
Objective:This study aimed to establish a nomogram to predict the risk of acute kidney injury(AKI)in patients undergoing Cox Maze Ⅲ procedure combined with cardiac valve surgery.Methods:Clinical data of 160 patients who underwent Cox Maze Ⅲ procedure combined with cardiac valve surgery in the General Hospital of Eastern Command from October 2015 to January 2023 were retrospectively collected.A nomogram was established after screening for relevant variables by univariate and multivariate logistic regression analysis.This nomogram was then evaluated by depicting the receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results:Overall,AKI occurred in 82 patients(51.3％),10(6.3％)requiring continuous renal replacement therapy.Multivariate logistic regression analysis showed that age,diabetesmellitus,use of contrast media 1 week before surgery,NYHA class ≥ 3,plasma infusion and hyperlacticemia were independent factors for AKI.The area under ROC curve(AUC)for the established nomogram was 0.847(95％CI:0.788～0.906),with a sensitivity of 70.73％and specificity of 84.62％,respectively.Depicted calibration curve demonstrated a well-fitted prediction and observation probability.In addition,decision curve analysis revealed that the established nomogram was significant for clinical decision-making.Conclusion:This study indicates that incidence of AKI is high in patients undergoing Cox Maze Ⅲ procedure combined with cardiac valve surgery,especially for those who were older or diabetic,received contrast medium 1 week before surgery,and had poor functional status(NYHA class≥3),peri-procedural plasma infusion,and hyperlacticemiapost operation.Using the nomogram constructed in this study could provide individual prediction of AKI which might benefit pre-and post-operative care for these patients.
维普
万方数据