Prediction of individual risk of acute kidney injury in urgent abdominal surgical pathology

Introduction. Surgical treatment of patients with urgent abdominal surgical pathology is associated with a high risk of developing various somatic complications. The most common of them is acute kidney injury (AKI), which is an independent factor in increasing the duration of hospitalization and mortality.

The objective was to develop a prognostic model of individual risk of AKI after surgical treatment of patients with urgent abdominal surgical pathology.

Materials and methods. A cohort comparative study of the treatment outcomes of 271 patients with urgent abdominal surgical pathology was conducted. The primary endpoint was the development of AKI. The main group included patients (N = 134) whose early postoperative period was complicated by AKI, and the control group (N = 137) included patients without this complication. Binary logistic regression analysis was used to build a model for predicting the probability of AKI development, which included statistically significant predictors. ROC analysis was performed to determine the sensitivity and specificity of the resulting individual risk model for AKI.

Results. It was proven that type 2 diabetes mellitus (p = 0.003), early stages of chronic kidney disease (p = 0.026), and mechanical jaundice (p < 0.001) were significantly more often verified in patients of the main group. In the AKI group, the levels of creatinine (p < 0.001), urea (p < 0.001) and proinflammatory cytokines – tumor necrosis factor alpha (p < 0.001) and C-reactive protein (p < 0.001) were significantly higher. Based on the obtained results, a model for predicting the individual risk of AKI was developed using binary logistic regression analysis, the sensitivity and specificity of which were 82.8% and 88.3%, respectively. High validity of the proposed model was proven.

Conclusion. The proposed model allows predicting a reliable individual risk of acute kidney injury after surgical treatment of patients with urgent abdominal surgical pathology.

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