Dataset Information

Derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin: cohort study.

ABSTRACT:

Objective

To develop and externally validate a prediction model for severe cisplatin associated acute kidney injury (CP-AKI).

Design

Multicenter cohort study.

Setting

Six geographically diverse major academic cancer centers across the US.

Participants

Adults (≥18 years) receiving their first dose of intravenous cisplatin, 2006-22.

Main outcome measures

The primary outcome was CP-AKI, defined as a twofold or greater increase in serum creatinine or kidney replacement therapy within 14 days of a first dose of intravenous cisplatin. Independent predictors of CP-AKI were identified using a multivariable logistic regression model, which was developed in a derivation cohort and tested in an external validation cohort. For the primary model, continuous variables were examined using restricted cubic splines. A simple risk model was also generated by converting the odds ratios from the primary model into risk points. Finally, a multivariable Cox model was used to examine the association between severity of CP-AKI and 90 day survival.

Results

A total of 24 717 adults were included, with 11 766 in the derivation cohort (median age 59 (interquartile range (IQR) 50-67)) and 12 951 in the validation cohort (median age 60 (IQR 50-67)). The incidence of CP-AKI was 5.2% (608/11 766) in the derivation cohort and 3.3% (421/12 951) in the validation cohort. Each of the following factors were independently associated with CP-AKI in the derivation cohort: age, hypertension, diabetes mellitus, serum creatinine level, hemoglobin level, white blood cell count, platelet count, serum albumin level, serum magnesium level, and cisplatin dose. A simple risk score consisting of nine covariates was shown to predict a higher risk of CP-AKI in a monotonic fashion in both the derivation cohort and the validation cohort. Compared with patients in the lowest risk category, those in the highest risk category showed a 24.00-fold (95% confidence interval (CI) 13.49-fold to 42.78-fold) higher odds of CP-AKI in the derivation cohort and a 17.87-fold (10.56-fold to 29.60-fold) higher odds in the validation cohort. The primary model had a C statistic of 0.75 and showed better discrimination for CP-AKI than previously published models, the C statistics for which ranged from 0.60 to 0.68 (DeLong P<0.001 for each comparison). Greater severity of CP-AKI was monotonically associated with shorter 90 day survival (adjusted hazard ratio 4.63 (95% CI 3.56 to 6.02) for stage 3 CP-AKI versus no CP-AKI).

Conclusion

This study found that a simple risk score based on readily available variables from patients receiving intravenous cisplatin could predict the risk of severe CP-AKI, the occurrence of which is strongly associated with death.

SUBMITTER: Gupta S

PROVIDER: S-EPMC10964715 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Publications

Derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin: cohort study.

Gupta Shruti S Glezerman Ilya G IG Hirsch Jamie S JS Chen Kevin L KL Devaraj Nishant N Wells Sophia L SL Seitter Robert H RH Kaunfer Sarah A SA Jose Arunima M AM Rao Shreya P SP Ortega Jessica L JL Green-Lingren Olivia O Hayden Robert R Bendapudi Pavan K PK Chute Donald F DF Sise Meghan E ME Jhaveri Kenar D KD Page Valda D VD Abramson Matthew H MH Motwani Shveta S SS Xu Wenxin W Sehgal Kartik K Reynolds Kerry L KL Bansal Anip A Abudayyeh Ala A Leaf David E DE

BMJ (Clinical research ed.) 20240327

<h4>Objective</h4>To develop and externally validate a prediction model for severe cisplatin associated acute kidney injury (CP-AKI).<h4>Design</h4>Multicenter cohort study.<h4>Setting</h4>Six geographically diverse major academic cancer centers across the US.<h4>Participants</h4>Adults (≥18 years) receiving their first dose of intravenous cisplatin, 2006-22.<h4>Main outcome measures</h4>The primary outcome was CP-AKI, defined as a twofold or greater increase in serum creatinine or kidney replac ...[more]

PMID: 38538012

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Dataset Information

Derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin: cohort study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin: cohort study.

Similar Datasets

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