Key result
The ACHE score (postoperative acute kidney injury, chronic kidney disease, and number of antihypertensive drugs) predicted end-stage renal disease after CABG with a C-statistic of 0.89.
Why the study?
End-stage renal disease increases morbidity and mortality, but no models had been developed or validated to predict ESRD in patients undergoing CABG.
Does the ACHE score accurately predict end-stage renal disease in patients undergoing coronary artery bypass grafting?
Cohort (n=3,368)
Yes
Does the ACHE score accurately predict end-stage renal disease in patients undergoing coronary artery bypass grafting?
Effect estimate: C-statistic 0.89 (95% CI 0.84-0.94)
The ACHE score, incorporating postoperative AKI, underlying CKD, and number of antihypertensive drugs, provides a simple and precise model for predicting ESRD after CABG.
ACHE score may aid post-CABG ESRD risk stratification; leaves open prospective validation before clinical use.
Because end-stage renal disease (ESRD) increases the risks of morbidity and mortality, early detection and prevention of ESRD is a critical issue in clinical practice. However, no ESRD-prediction models have been developed or validated in patients undergoing coronary artery bypass grafting (CABG).This is a retrospective multicenter cohort study, recruited between January 2004 and December 2015. A cohort of 3089 patients undergoing CABG in two tertiary referral centers was analyzed to derive a risk-prediction model. The model was developed using Cox proportional hazard analyses, and its performance was assessed using C-statistics. The model was externally validated in an independent cohort of 279 patients.During the median follow-up of 6 years (maximum 13 years), ESRD occurred in 60 patients (2.0%). Through stepwise selection multivariate analyses, the following three variables were finally included in the ESRD-prediction model: postoperative Acute kidney injury, underlying Chronic kidney disease, and the number of antiHypertensive drugs (ACHE score). This model showed good performance in predicting ESRD with the following C-statistics: 0.89 (95% confidence interval [CI] 0.84-0.94) in the development cohort and 0.82 (95% CI 0.60-1.00) in the external validation cohort.The present ESRD-prediction model may be applicable to patients undergoing CABG, with the advantage of simplicity and preciseness.
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Lee et al. (2019) conducted a cohort in Coronary artery bypass grafting (CABG) (n=3,368). ACHE score (postoperative Acute kidney injury, underlying Chronic kidney disease, and number of antiHypertensive drugs) was evaluated on End-stage renal disease (ESRD) (C-statistic 0.89, 95% CI 0.84-0.94). The ACHE score (postoperative acute kidney injury, chronic kidney disease, and number of antihypertensive drugs) predicted end-stage renal disease after CABG with a C-statistic of 0.89.
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