DEVELOPMENT AND VALIDATION OF A PREDICTION MODEL FOR SEPTIC SHOCK-ASSOCIATED ACUTE KIDNEY INJURY: A MULTICENTER STUDY USING NOMOGRAM MODELING
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View abstract on PubMed
Summary
This summary is machine-generated.This study identified key risk factors for acute kidney injury (AKI) in septic shock patients and developed a nomogram for risk prediction. The nomogram helps clinicians assess AKI risk and enable timely interventions.
Area Of Science
- Nephrology
- Critical Care Medicine
- Medical Informatics
Background
- Septic shock-associated acute kidney injury (SS-AKI) is a critical condition with significant mortality.
- Early identification of patients at risk for SS-AKI is crucial for effective management.
- Predictive models can aid clinicians in assessing SS-AKI risk.
Purpose Of The Study
- To identify risk factors for acute kidney injury (AKI) in patients with septic shock.
- To develop and validate a predictive nomogram for SS-AKI occurrence.
- To improve clinical decision-making for SS-AKI prevention and management.
Main Methods
- A retrospective study of 507 septic shock patients, divided into training (n=355) and validation (n=152) sets.
- Binary logistic regression analysis to identify significant risk factors for AKI.
- Nomogram construction and evaluation using ROC analysis, calibration curves, and decision curve analysis.
Main Results
- 174 (34.3%) patients developed AKI.
- Key predictive factors included chronic kidney disease, diuretic use, deresuscitation, mechanical ventilation, source control failure, restrictive fluid resuscitation, and SOFA scores.
- The nomogram demonstrated excellent predictive performance with AUCs of 0.788 (training) and 0.770 (validation).
Conclusions
- The developed nomogram is a valuable tool for assessing SS-AKI risk in clinical practice.
- Early risk assessment facilitates timely interventions to potentially improve patient outcomes.
- The nomogram shows strong discriminatory ability and clinical utility in both training and validation cohorts.
Keywords:
AKI—acute kidney injury APACHE II—Acute Physiology and Chronic Health Evaluation II AUC—area under the curve Acute kidney injury CKD—chronic kidney disease CRRT—continuous renal replacement therapy DCA—decision curve analysis EMRS—electronic medical record system KDIGO—Kidney Disease Improving Global Outcomes ML—machine learning MV—mechanical ventilation RFR—restricted fluid resuscitation ROC—receiver operating characteristic SA-AKI—sepsis-associated acute kidney injury SOFA—Sequential Organ Failure Assessment SS-AKI—septic shock–associated acute kidney injury deresuscitation restricted fluid resuscitation septic shock source control
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