Risk stratification nomogram for nephropathy after abdominal contrast-enhanced computed tomography

Area of Science:

• Radiology
• Nephrology
• Medical Informatics

Background:

• Abdominal contrast-enhanced computed tomography (A-CECT) is a common emergency department imaging modality.
• Contrast-induced nephropathy (CIN) is a known risk associated with A-CECT.
• Accurate risk stratification for CIN is crucial for patient management.

Purpose of the Study:

• To develop and validate a predictive nomogram for nephropathy following emergency A-CECT.
• To identify key clinical variables associated with CIN risk.
• To enable individualized risk assessment before contrast administration.

Main Methods:

• Retrospective analysis of 750 patients undergoing emergency A-CECT with pre- and post-procedure serum creatinine (SCr) measurements.
• Nephropathy defined by SCr increase (≥0.5 mg/dL or ≥25% from baseline).
• Multivariate logistic regression used to develop a nomogram based on pre-procedural clinical variables; internal validation via bootstrapping.

Main Results:

• Nephropathy occurred in 34 of 750 patients (4.5%).
• A predictive nomogram was developed using age and baseline SCr as significant risk factors.
• The model demonstrated fair diagnostic accuracy with an Area Under the Curve (AUC) of 0.794.

Conclusions:

• An internally validated nomogram effectively predicts individual nephropathy risk after emergency A-CECT.
• The nomogram utilizes readily available pre-procedural clinical variables.
• This tool can aid clinicians in managing CIN risk in emergency settings.