Key result
The Wang et al. prediction model and the Forman risk score demonstrated the most favorable discrimination for predicting acute kidney injury in patients with acute heart failure, with AUCs of 0.73 and 0.696, respectively.
Why the study?
AKI is common in acute heart failure and is linked to prolonged hospitalization and increased mortality, prompting external validation of existing AKI prediction models.
Do existing prediction models accurately predict acute kidney injury in patients hospitalized for acute heart failure?
Cohort (n=10,364)
Yes
Do existing prediction models accurately predict acute kidney injury in patients hospitalized for acute heart failure?
Effect estimate: AUC 0.73 (95% CI 0.715-0.744)
Absolute Event Rate: 73% vs 69.6%
The Forman risk score and the Wang et al. prediction model are simple and accurate tools for predicting acute kidney injury in patients hospitalized with acute heart failure.
Wang and Forman models offer moderate AKI discrimination in acute HF; leaves open clinical adoption pending prospective validation.
Acute kidney injury (AKI) is a common complication in acute heart failure (AHF) and is associated with prolonged hospitalization and increased mortality. The aim of this study was to externally validate existing prediction models of AKI in patients with AHF. Data for 10,364 patients hospitalized for acute heart failure between 2008 and 2018 were extracted from the Chang Gung Research Database and analysed. The primary outcome of interest was AKI, defined according to the KDIGO definition. The area under the receiver operating characteristic (AUC) curve was used to assess the discrimination performance of each prediction model. Five existing prediction models were externally validated, and the Forman risk score and the prediction model reported by Wang et al. showed the most favourable discrimination and calibration performance. The Forman risk score had AUCs for discriminating AKI, AKI stage 3, and dialysis within 7 days of 0.696, 0.829, and 0.817, respectively. The Wang et al. model had AUCs for discriminating AKI, AKI stage 3, and dialysis within 7 days of 0.73, 0.858, and 0.845, respectively. The Forman risk score and the Wang et al. prediction model are simple and accurate tools for predicting AKI in patients with AHF.
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Lee et al. (2021) conducted a cohort in Acute heart failure (n=10,364). Wang et al. prediction model vs. Other AKI prediction models (Forman, Basel, Verdiani, Zhou) was evaluated on Acute kidney injury (AKI) within 7 days (AUC 0.73, 95% CI 0.715-0.744). The Wang et al. prediction model and the Forman risk score demonstrated the most favorable discrimination for predicting acute kidney injury in patients with acute heart failure, with AUCs of 0.73 and 0.696, respectively.
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