Key result
High ACEF score predicts ~160% higher AKI risk after SAVR.
Why the study?
Acute kidney injury is a common complication after aortic valve replacement linked to worse outcomes, but whether the simple ACEF score predicts AKI after AVR was unknown.
Does the ACEF score predict the development of acute kidney injury in patients undergoing surgical aortic valve replacement?
Cohort (n=366)
No
Does the ACEF score predict the development of acute kidney injury in patients undergoing surgical aortic valve replacement?
Effect estimate: OR 2.599 (95% CI 1.399-4.828)
Absolute Event Rate: 26.1% vs 10.5%
p-value: p=0.002
The ACEF score is a simple, independent predictor of acute kidney injury following surgical aortic valve replacement, which can help identify high-risk patients for renal protective measures.
High ACEF score was associated with post-SAVR AKI; hypothesis-generating and requires prospective validation before adoption.
Objectives: Aortic stenosis is the most common form of degenerative heart valve disease. Acute kidney injury (AKI) after aortic valve replacement (AVR) is a common complication and is related to worse outcomes. Age, creatinine, and ejection fraction (ACEF) score is a simple scoring method that includes three parameters. Our study aimed to evaluate whether ACEF score could predict the development of AKI in patients who underwent AVR. Methods: A total of 366 consecutive patients who underwent isolated AVR for symptomatic severe aortic stenosis were evaluated retrospectively. The development of AKI was the primary endpoint of the study. The ACEF score was calculated by the formula: age (years)/left ventricular ejection fraction (%) + 1 (if baseline serum creatinine was >2 mg/dL). According to the ACEF score the study population was divided into two groups. Results: AKI was developed in 66 (18%) patients. The cut-off value of the ACEF score for the prediction of AKI was 1.07 with a sensitivity of 69.7% and a specificity of 56.7% (AUC 0.663; 95% CI: 0.589-0.736; P<0.001). AKI incidence was found to be higher in patients with high ACEF score than low ACEF score [46 (26.1%) vs. 20 (10.5%); P<0.001]. In addition, ACEF score [OR: 2.599; 95% CI: 1.399-4.828; P=0.002] and hemoglobin levels (OR: 0.837; 95% CI: 0.729-0.961; P=0.012) were found to be independent predictors of AKI. Conclusions: Our study revealed that the ACEF score is an independent predictor of AKI. ACEF score, as a simple and objective score, can be useful in predicting AKI in patients undergoing AVR.
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Demirci et al. (2023) conducted a cohort in Severe degenerative aortic stenosis (n=366). High ACEF score (>1.07) vs. Low ACEF score (≤1.07) was evaluated on Development of acute kidney injury (AKI) (OR 2.599, 95% CI 1.399-4.828, p=0.002). A high ACEF score (>1.07) independently predicted the development of acute kidney injury after surgical aortic valve replacement (OR 2.599).
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