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Performance of a pre-procedural Mehran score to predict acute kidney injury after percutaneous coronary intervention

Anamarys Blanco1,2, Faisal Rahim1,2, Michelle Nguyen1,2

  • 1GME department, University of Central Florida College of Medicine, Orlando, Florida, USA.

Nephrology (Carlton, Vic.)
|August 19, 2020
PubMed

Insights

A modified Mehran score, excluding contrast volume, effectively predicts acute kidney injury (AKI) risk in patients undergoing percutaneous coronary interventions (PCI). This pre-procedural tool aids in identifying at-risk individuals for AKI.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Informatics

Background:

  • Acute kidney injury (AKI) is a significant complication following cardiac catheterization and percutaneous coronary interventions (PCI).
  • The existing Mehran score aids in AKI risk prediction but includes contrast volume, limiting its pre-procedural utility.
  • A need exists for a pre-procedural risk assessment tool for AKI in PCI patients.

Purpose of the Study:

  • To evaluate a modified Mehran score that excludes contrast volume for predicting AKI risk.
  • To assess the discriminative ability of the pre-procedural Mehran score compared to the original Mehran score.

Main Methods:

  • Retrospective analysis of 1,507 patients undergoing PCI between July 2015 and December 2017.
  • Comparison of the original Mehran score with a modified version excluding contrast volume.
  • Receiver-operator characteristic (ROC) curve analysis to evaluate discriminative ability.

Main Results:

  • 4.6% of patients (70/1507) developed AKI.
  • The modified (pre-procedural) Mehran score showed a small decrease in discrimination (AUROC 0.73 vs. 0.74).
  • Net Discrimination Index (NDI) and Integrated Discrimination Index (IDI) indicated comparable performance between the scores.

Conclusions:

  • The modified Mehran score, using only pre-procedural data, is a valuable tool for predicting AKI risk in PCI patients.
  • Despite a minor reduction in discriminative ability, the pre-procedural score maintains clinical utility.
  • This modified score enhances pre-procedural risk stratification for AKI in PCI.
Abstract

Keywords:
Mehran scoreacute kidney injurycardiac catheterizationspercutaneous coronary interventions

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