Development and Validation of an Enhanced Prediction Score for Postoperative Acute Renal Failure After Liver Resection

University of Zurich (UZH)

Status: Completed

Conditions: Acute Renal Failure

Study type: Observational

Funder types: Other

Identifiers

NCT01318798

StV 33-2009

Details and patient eligibility

About

Post-operative acute renal failure is a severe post-operative complication and is associated with high mortality. The enhanced prediction score, including pre-as well as intra-operative predictors accurately predicted ARF following hepatic surgery. This prediction score allows early identification of patients at high risk of ARF and may support decision-making for protective kidney treatment.

Full description

To enhance and validate an already pre-existing score accurately predicting post-operative acute renal failure (ARF) after hepatic surgery

We will enhance a pre-existing score predicting ARF based on pre-operative as well as intra-operative predictors.

Development process: we will identify the strongest predictors of ARF in a multivariable logistic regression model followed by a stepwise backward logistic regression analysis and bootstrapping.

Validation process: we will perform an internal validation by calibrating the prediction model as well as by k-fold cross validation (c statistics) and bootstrapping. Additionally, we will calculate the discrimination by the area under the curve (AUC).

Decision curve analysis: Furthermore we will perform a decision curve analysis to evaluate the clinical consequences of both prediction scores whether a patient with increased ARF risk would post-operative benefit of a treatment on the ICU.

Enrollment: 549 patients

Sex: All

Ages: 18 to 95 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• > 18 years
• scheduled for liver surgery
• benign as well as malignant diseases

Exclusion criteria

• liver trauma
• incomplete data sets
• pre-operative chronic renal failure requiring hemodialysis

Trial design

549 participants in 2 patient groups

Patients with post-operative ARF

Description:

Patients developing acute renal failure (ARF) following liver surgery ARF was defined according to the RIFLE criteria as an absolute increase in serum-creatinine of more than 0.3 mg/dl above baseline, or an increase of more than 1.5 times the pre-operative baseline value within 48 hours after surgery, or a reduction of urinary output less than 0.5 ml/kg/h for at least 6 hrs.

Patients without post-operative ARF

Description:

Patients with normal kidney function (without acute renal failure (ARF)) following liver surgery