Table 5.
Comparison of the association between different AKI definitions and adverse outcomes in multivariable logistic regression models for training and validation cohorts
| RIFLE-AKI Model (compared to no RIFLE-AKI) |
Percent change in sCr Model (for every 10% change) |
KDIGO-AKI Model (compared to no KDIGO-AKI) |
Absolute Change in sCr Model (for every 0.1 mg/dl change) |
|
|---|---|---|---|---|
|
| ||||
| Hospital mortality* | ||||
| OR (95% CI) | 10.67 (8.59, 13.26) | 1.05 (1.04, 1.06) | 10.04 (7.94, 12.68) | 1.08 (1.08, 1.09) |
| Training AUC (95% CI) | 0.84 (0.84, 0.86) | 0.87 (0.86, 0.89) | 0.84 (0.83, 0.85) | 0.87 (0.87, 0.89) |
| Validation AUC (95% CI) | 0.86 (0.84, 0.88) | 0.87 (0.87, 0.90) | 0.85 (0.83, 0.88) | 0.87 (0.85, 0.89) |
|
| ||||
| 90-day mortality* | ||||
| OR (95% CI) | 3.26 (2.90, 3.67) | 1.03 (1.03, 1.04) | 2.94 (2.60, 3.33) | 1.06 (1.06, 1.07) |
| Training AUC (95% CI) 1 | 0.81 (0.80, 0.82) | 0.82 (0.81, 0.83) | 0.80 (0.79, 0.81) | 0.82 (0.81, 0.83) |
| Validation AUC (95% CI)1 | 0.84 (0.82, 0.86) | 0.85 (0.83, 0.87) | 0.83 (0.81, 0.86)** | 0.85 (0.83, 0.87) |
|
| ||||
| Sepsis* | ||||
| OR (95% CI) | 15.97 (12.81, 19.91) | 1.06 (1.05, 1.06) | 15.49 (12.17, 19.72) | 1.09 (1.08, 1.09) |
| Training AUC (95% CI) | 0.83 (0.83, 0.84) | 0.87 (0.86, 0.88) | 0.82 (0.81, 0.83) | 0.84 (0.83, 0.86) |
| Validation AUC (95% CI) | 0.86 (0.85, 0.88)** | 0.87 (0.85, 0.89) | 0.85 (0.83, 0.87)** | 0.85 (0.83, 0.87) |
|
| ||||
| Severe sepsis* | ||||
| OR (95% CI) | 31.02 (22.66, 42.47) | 1.06 (1.05, 1.06) | 30.84 (21.70, 43.84) | 1.10 (1.09, 1.10) |
| Training AUC (95% CI) | 0.85 (0.84, 0.86) | 0.89 (0.88, 0.9) | 0.84 (0.83, 0.85) | 0.87 (0.86, 0.88) |
| Validation AUC (95% CI) | 0.88 (0.86, 0.90)** | 0.89 (0.86, 0.91) | 0.87 (0.85, 0.88)** | 0.87 (0.84, 0.89) |
|
| ||||
| Postoperative surgical infection* | ||||
| OR (95% CI) | 2.21 (1.97, 2.47) | 1.02 (1.01, 1.02) | 2.14 (1.91, 2.40) | 1.03 (1.02,1.03) |
| Training AUC (95% CI) | 0.67 (0.66, 0.69) | 0.66 (0.64, 0.67) | 0.67 (0.65, 0.68) | 0.65 (0.64, 0.67) |
| Validation AUC (95% CI) | 0.68 (0.65, 0.72) | 0.67 (0.64, 0.7) | 0.68 (0.65, 0.72) | 0.67 (0.64, 0.7) |
|
| ||||
| Mechanical wound complications* | ||||
| OR (95% CI) | 2.39 (2.15, 2.66) | 1.02 (1.01, 1.02) | 2.26 (2.03, 2.51) | 1.03 (1.02, 1.03) |
| Training AUC (95% CI) | 0.65 (0.65, 0.67) | 0.63 (0.68, 0.65) | 0.65 (0.64, 0.67) | 0.63 (0.61, 0.64) |
| Validation AUC (95% CI) | 0.66 (0.63, 0.69) | 0.64 (0.61, 0.67) | 0.66 (0.63, 0.69) | 0.64 (0.61, 0.67) |
|
| ||||
| Procedural complications* | ||||
| OR (95% CI) | 4.42 (4.13, 4.73) | 1.02 (1.02, 1.02) | 2.55 (2.30, 2.83) | 1.03 (1.03, 1.04) |
| Training AUC (95% CI) | 0.65 (0.64, 0.66) | 0.63 (0.61, 0.64) | 0.65 (0.63, 0.66) | 0.63 (0.61, 0.64) |
| Validation AUC (95% CI) | 0.68 (0.65, 0.71) | 0.66 (0.63, 0.7) | 0.68 (0.65, 0.72) | 0.66 (0.63, 0.69) |
|
| ||||
| Mechanical ventilation* | ||||
| OR (95% CI) | 9.59 (8.58, 10.73) | 1.06 (1.06, 1.06) | 4.29 (4.01, 4.59) | 1.09 (1.08, 1.09) |
| Training AUC (95% CI) | 0.82 (0.82, 0.83) | 0.81 (0.81, 0.82) | 0.82 (0.81, 0.82) | 0.80 (0.80, 0.81) |
| Validation AUC (95% CI) | 0.84 (0.83, 0.85)** | 0.84 (0.83, 0.85)** | 0.83 (0.82, 0.84)** | 0.82 (0.81, 0.83) ** |
|
| ||||
| Long term mechanical ventilation* | ||||
| OR (95% CI) | 7.53 (6.67, 8.52) | 1.06 (1.05, 1.06) | 6.15 (5.43, 6.97) | 1.08 (1.07, 1.08) |
| Training AUC (95% CI) | 0.81 (0.80, 0.82) | 0.81 (0.80, 0.82) | 0.79 (0.78, 0.80) | 0.79 (0.77, 0.8) |
| Validation AUC (95% CI) | 0.83 (0.81, 0.85) | 0.83 (0.81, 0.85) | 0.81 (0.79, 0.83) | 0.80 (0.78, 0.83) |
|
| ||||
| Pulmonary complications* | ||||
| OR (95% CI) | 3.85 (3.49, 4.23) | 1.03 (1.02, 1.03) | 3.68 (3.33, 4.07) | 1.05 (1.04, 1.05) |
| Training AUC (95% CI) | 0.72 (0.71, 0.73) | 0.70 (0.68, 0.71) | 0.71 (0.70, 0.72) | 0.69 (0.67, 0.70) |
| Validation AUC (95% CI) | 0.72 (0.70, 0.74) | 0.70 (0.67, 0.72) | 0.71 (0.69, 0.73) | 0.69 (0.66, 0.71) |
|
| ||||
| Cardiovascular complications* | ||||
| OR (95% CI) | 2.24 (1.98, 2.53) | 1.01 (1.01, 1.02) | 2.38 (2.09, 2.70) | 1.03 (1.02, 1.03) |
| Training AUC (95% CI) | 0.75 (0.73, 0.76) | 0.74 (0.73, 0.75) | 0.75 (0.74, 0.76) | 0.74 (0.72, 0.75) |
| Validation AUC (95% CI) | 0.74 (0.72, 0.77) | 0.74 (0.71, 0.76) | 0.74 (0.71, 0.77) | 0.74 (0.71, 0.76) |
|
| ||||
| Neurological complications* | ||||
| OR (95% CI) | 2.63 (2.21, 3.13) | 1.02 (1.01, 1.02) | 2.51 (2.11, 2.98) | 1.04 (1.03, 1.04) |
| Training AUC (95% CI) | 0.85 (0.84, 0.87) | 0.85 (0.84, 0.86) | 0.85 (0.84, 0.87) | 0.85 (0.84, 0.86) |
| Validation AUC (95% CI) | 0.86 (0.84, 0.89) | 0.85 (0.82, 0.88) | 0.86 (0.83, 0.89) | 0.84 (0.82, 0.88) |
|
| ||||
| GI complications* | ||||
| OR (95% CI) | 2.56 (2.23, 2.94) | 1.01 (1.01, 1.02) | 2.51 (2.18, 2.89) | 1.03 (1.02,1.04) |
| Training AUC (95% CI) | 0.75 (0.73, 0.76) | 0.73 (0.71, 0.75) | 0.75 (0.73, 0.76) | 0.73 (0.71, 0.75) |
| Validation AUC (95% CI) | 0.78 (0.74, 0.81) | 0.76 (0.73, 0.80) | 0.78 (0.75, 0.81) | 0.76 (0.73, 0.80) |
For detailed models description see Statistical Analysis.
1
Training AUC (95% CI) and validation AUC (95% CI) indicate area under receiver operator curve with 95% confidence intervals for each model applied in training and validation cohort, respectively.
*
p-value < 0.05 for difference in AUC (95% CI) between the models fit for each listed AKI definition compared to NSQIP-AKI model.
**
p-value < 0.05 for difference in AUC (95% CI) between the models fit to training cohort and validation cohort.