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MO315: Risk Factors for CSA-AKI and Performance of Leicester Score in a Spanish Cohort


 
 
 The incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30% and it places patients at an increased risk of death. Leicester score (LS) is a new score designed by Birnie et al. [1] and validated in 2014 in a British Cohort. It predicts CSA-AKI at any stage with better discrimination compared with the Clevaland Clinic Score (CCS) and Euroscore II. The aim of this study was to identify risk factors for CSA-AKI and to assess the performance of LS in a Spanish cohort.
 
 
 
 A unicentric retrospective study of patients that required cardiac surgery with cardio-pulmonary bypass (CPB) during 2015 in the Hospital Clinic de Barcelona. The inclusion criteria were patients >18 years old who were operated on for cardiac surgery [valve substitution (VS), coronary artery bypass graft (CABG) or a combination of both procedures] with the need of CPB. CSA-AKI was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria.
 
 
 
 A total of 444 patients were included, of which 171 (38.5%) developed CSA-AKI. The most frequent form of AKI was mild AKI (AKI stage 1), which was present in 105 patients (61.4%). AKI stage 3 was developed in 26 patients, 15 of which required RRT. A total of 66.7% of AKI cases met criteria in the first 24 h and the median duration until total recovery was 3 days. In the multivariate analysis, hypertension (OR 1.883), EGFR < 60 mL/min (OR 2.365) and peripheral vascular disease (OR 4.66) were associated with CSA-AKI. Either discrimination or calibration were better with LS compared with CCS and Euroscore II, with an AUC of 0.721 versus 0.595 and 0.662, respectively (Fig. 1).
 
 
 
 Preoperative hypertension in patients with CKD with or without peripheral vasculopathy can identify patients at risk of CSA-AKI. LS has proved to be a valid score that could be used to identify patients at risk who could benefit in intervention studies.
