Serious Renal Dysfunction Post-PCI
Assess risk of dialysis or severe increase in creatinine after PCI
This model was developed utilizing preprocedural patient characteristics could be used to predict the risk of serious renal dysfunction (SRD) after percutaneous coronary intervention (PCI). Serious renal dysfunction was defined as Serious renal dysfunction is defined as new dialysis, ≥2.0 mg/dL / 176 µmol/L absolute increase in creatinine, or a ≥50% increase in creatinine.
Serious renal dysfunction only occurred in 0.74% of patients but was associated with in-hospital mortality of 19.3% versus 0.9% in those without SRD. The model was able to distinguish well between patients who did and did not develop SRD after PCI (ROC 0.87, 95% CI 0.82-0.91).
76% of the model's predictive ability were related to preprocedural creatinine (37%), congestive heart failure (24%), and diabetes (15%). The other factors contributed an additional 24%: case priority (10%), preprocedural intra-aortic balloon pump use (8%), age ≥80 years (5%), and female sex (1%). The model was successfully validated with an ROC 0.84 (95% CI 0.80-0.89).
It is hoped that this model may lead to targeted interventions that could reduce the risk of serious renal dysfunction after PCI.
- [1]Brown JR, DeVries JT, Piper WD, et al.: Serious renal dysfunction after percutaneous coronary interventions can be predicted.American Heart Journal 2008, 155 (2): 260-6
Results
Real-time automated computation
This model was developed utilizing preprocedural patient characteristics could be used to predict the risk of serious renal dysfunction (SRD) after percutaneous coronary intervention (PCI). Serious renal dysfunction was defined as Serious renal dysfunction is defined as new dialysis, ≥2.0 mg/dL / 176 µmol/L absolute increase in creatinine, or a ≥50% increase in creatinine.
Serious renal dysfunction only occurred in 0.74% of patients but was associated with in-hospital mortality of 19.3% versus 0.9% in those without SRD. The model was able to distinguish well between patients who did and did not develop SRD after PCI (ROC 0.87, 95% CI 0.82-0.91).
76% of the model's predictive ability were related to preprocedural creatinine (37%), congestive heart failure (24%), and diabetes (15%). The other factors contributed an additional 24%: case priority (10%), preprocedural intra-aortic balloon pump use (8%), age ≥80 years (5%), and female sex (1%). The model was successfully validated with an ROC 0.84 (95% CI 0.80-0.89).
It is hoped that this model may lead to targeted interventions that could reduce the risk of serious renal dysfunction after PCI.
- [1]Brown JR, DeVries JT, Piper WD, et al.: Serious renal dysfunction after percutaneous coronary interventions can be predicted.American Heart Journal 2008, 155 (2): 260-6