Analysis of influencing factors for acute kidney injury after cardiac arrest and establishment of prediction model
Objective To analyze the influencing factors for acute kidney injury(AKI)after cardiac arrest(CA)and establish the prediction model.Methods A total of 255 CA patients from 2018 to 2021 were selected as the training set,and 84 CA patients in 2022 were selected as the validation set.In the training set,AKI was occurred in 114 cases(AKI group)and 141 cases had no AKI(non-AKI group).The clinical data of the two groups were analyzed.The influencing factors for AKI after CA were analyzed by logistic regression analysis,and nomogram model was established.ROC curve,calibration curve and decision curve were used to evaluate the predictive value of nomogram model for AKI after CA.Results Compared with non-AKI group,AKI group had higher proportions of chronic kidney disease(CKD)and post-resuscitation shock,faster heart rate,higher serum levels of creatinine and lactic acid,longer recovery time of autonomic circulation,and lower MAP and albumin level(P＜0.05).Multivariate logistic regression analysis showed that CKD,faster heart rate and post-resuscitation shock were the independent risk factors for AKI after CA,and higher albumin level was the independent protective factor(P＜0.05).Nomogram model was constructed based on the above influencing factors.In the training set and validation set,the AUC of the nomogram model predicting AKI after CA was 0.777 and 0.751,respectively.The calibration curve showed that the nomogram model had good calibration ability in both training set and validation set.The decision curve showed that when the threshold probability was 7％to 75％,nomogram model in training set had a significant positive net benefit.When the threshold probability was 16％to 71％,nomogram model in validation set had a significant positive net benefit.Conclusion CKD,faster heart rate and post-resuscitation shock are the independent risk factors for AKI after CA,and higher albumin level is the independent protective factor.The nomogram model has good predictive ability for the occurrence of AKI after CA.
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