A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

Abstract

Introduction: Acute kidney injury (AKI) in coronavirus disease 2019 patients is associated with poor prognosis. Early prediction and intervention of AKI are vital for improving clinical outcome of COVID-19 patients. As lack of tools for early AKI detection in COVID-19 patients, this study aimed to validate the USCD-Mayo risk score in predicting hospital-acquired AKI in an extended multi-center COVID-19 cohort. Methods: Five hundred seventy-two COVID-19 patients from Wuhan Tongji Hospital Guanggu Branch, Wuhan Leishenshan Hospital, and Wuhan No. Ninth Hospital was enrolled for this study. Patients who developed AKI or reached an outcome of recovery or death during the study period were included. Predictors were evaluated according to data extracted from medical records. Results: Of all patients, a total of 44 (8%) developed AKI. The UCSD-Mayo risk score achieved excellent discrimination in predicting AKI with the C-statistic of 0.88 (95%CI: 0.84-0.91). Next, we determined the UCSD-Mayo risk score had good overall performance (Nagelkerke R 2 ¼ 0.32) and calibration in our cohort. Further analysis showed that the UCSD-Mayo risk score performed well in subgroups defined by gender, age, and several chronic comorbidities. However, the discrimination of the UCSD-Mayo risk score in ICU patients and patients with mechanical ventilation was not good which might be resulted from different risk factors of these patients. Conclusions: We validated the performance of UCSD-Mayo risk score in predicting hospitalacquired AKI in COVID-19 patients was excellent except for patients from ICU or patients with mechanical ventilation.

Development and validation of the MMCD score to predict kidney replacement therapy in COVID-19 patients

“…However, there is a lack of evidence in this context. Fang et al used a score created before the pandemic (UCSD-Mayo risk score) and analysed its efficiency in predicting hospital-acquired AKI in patients with COVID-19, but the performance of the score in patients in ICUs or under mechanical ventilation was not satisfactory [6].…”

Outcomes, Healthcare Resource Utilization, and Costs of Overall, Community-Acquired, and Hospital-Acquired Acute Kidney Injury in COVID-19 Patients

“…Our results have important implications for management of hospitalized COVID-19 patients. In hospitalized patients with and without COVID-19, studies demonstrate improved identification of patients at risk for AKI using risk scores, 47,48 or other biomarkers, 49 especially urinary biomarkers. [24][25][26]50,51 Several studies, including randomized controlled trials, have shown that urinary biomarkerguided use of the KDIGO bundle resulted in lower incidence of stage 2/3 AKI [24][25][26] and e-alert-guided use of the KDIGO bundle was associated with improved AKI recovery (reversal) within 7 days 27 and with reduced LOS 28 and costs.…”

Outcomes, Healthcare Resource Utilization, and Costs of Overall, Community-Acquired, and Hospital-Acquired Acute Kidney Injury in COVID-19 Patients

“…Our results have important implications for management of hospitalized COVID-19 patients. In hospitalized patients with and without COVID-19, studies demonstrate improved identification of patients at risk for AKI using risk scores, 47,48 or other biomarkers, 49 especially urinary biomarkers. [24][25][26]50,51 Several studies, including randomized controlled trials, have shown that urinary biomarkerguided use of the KDIGO bundle resulted in lower incidence of stage 2/3 AKI [24][25][26] and e-alert-guided use of the KDIGO bundle was associated with improved AKI recovery (reversal) within 7 days 27 and with reduced LOS 28 and costs.…”