Document Detail

Validation of a clinical score to determine the risk of acute renal failure after cardiac surgery.
MedLine Citation:
PMID:  19716313     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Preoperative assessment of risk factors for postoperative acute renal failure (ARF) is a key point in the management of cardiac surgery patients. A reliable evaluation of individual risk permits the efficient application of prophylactic and therapeutic measures to patients with increased risk of ARF. In 2005, Thakar published a scoring system to determine the ARF risk prior to surgery. The score allowed calculation of the incidence of postoperative ARF requiring dialysis (ARF-D) with a high level of precision.
METHODS: In order to examine the reproducibility of the results on different patient populations, we retrospectively applied the scoring system to 3,508 cardiac surgery patients at the Goettingen University Hospital.
RESULTS: We found a qualitative correlation between the score value and ARF-D, but prognostic significance, when judged by the area under the receiver operating characteristic (ROC) curve, was considerably reduced. Also, the incidence of ARF-D in the Goettingen population was remarkably higher than the incidence shown by Thakar for patients with the same score.
CONCLUSIONS: The correlation between score values and incidence of ARF-D shows that the Thakar score is qualitatively transferable to cardiac surgery patients from other centres. Though the score allows the discrimination between patients with higher or lower risks of ARF-D within the Goettingen collective, it was not suitable to estimate the real incidence of postoperative ARF-D with sufficient precision.
Daniel Heise; Daniela Sundermann; Anselm Braeuer; Michael Quintel
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2009-08-27
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  37     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  710-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Department of Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Goettingen, Goettingen, Germany.
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MeSH Terms
Acute Kidney Injury / etiology*,  therapy
Aged, 80 and over
Cardiac Surgical Procedures / adverse effects*
Epidemiologic Methods
Middle Aged
Preoperative Care / methods
Renal Replacement Therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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