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Development of a risk scoring system for predicting acute kidney injury after minimally invasive partial and radical nephrectomy: a retrospective study

Authors
 Na Young Kim  ;  Dongwoo Chae  ;  Jongsoo Lee  ;  Byunghag Kang  ;  Kyungsoo Park  ;  So Yeon Kim 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.35(4) : 1626-1635, 2021-04 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2021-04
Keywords
Acute kidney injury ; Minimally invasive surgical procedures ; Nephrectomy ; Risk scoring
Abstract
Background: Acute kidney injury after partial or radical nephrectomy remains an unsolved problem even when using minimally invasive techniques. We aimed to identify risk factors for acute kidney injury (AKI) after minimally invasive nephrectomy and to develop a clinical risk scoring system. Methods: Medical records of 1762 patients who underwent minimally invasive laparoscopic or robot-assisted laparoscopic partial (n = 1009) or radical (n = 753) nephrectomy from December 2005 to November 2018 were reviewed. Candidate risk factors were screened using univariate analysis and ranked using linear discriminant analysis; top ranking factors were incorporated into a multivariate logistic regression model. Then, the final clinical scoring system was created based on the estimated odds ratios. Results: The incidence of acute kidney injury after partial or radical nephrectomy was 20.3 and 61.6%, respectively. Risk factors incorporated into the scoring system included: size of the parenchymal mass removed (3 < parenchymal mass ≤ 4 cm, 1 point; 4 < parenchymal mass ≤ 6 cm, 3 points; parenchymal mass > 6 cm, 5 points), male sex (2 points), diabetes mellitus (1 point), warm ischemia time ≥ 25 min (1 point), and immediate postoperative neutrophil count ≥ 12,000 µl-1 (1 point) in patients with partial nephrectomy, and sex (male, 10 points; female, 7 points) in patients with radical nephrectomy. For risk scores of 0-4, 5-6, 7, 8-9, and 10 points, the probabilities of acute kidney injury were approximately 10, 20, 40, 60, and 80%, respectively. The predictive accuracy of the scoring system was 0.827 (95% CI 0.789-0.865). Conclusion: Our risk scoring system could help clinicians identify those at risk of acute kidney injury after minimally invasive partial or radical nephrectomy, thereby optimizing postoperative management.
Full Text
https://link.springer.com/article/10.1007%2Fs00464-020-07545-0
DOI
10.1007/s00464-020-07545-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Park, Kyungsoo(박경수) ORCID logo https://orcid.org/0000-0002-6972-1143
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
Chae, Dong Woo(채동우) ORCID logo https://orcid.org/0000-0002-7675-3821
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182288
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