The predictive value of AKI risk score for mortality risk in the patients with sepsis

Wang Wenwen; Yuan Yuan; Wang Yueguo; Wang Yulan; Sun Jian; Xu Jun; Jin Kui

doi:10.3969/j.issn.1002-1949.2024.04.005

Abstract：Objective To investigate the predictive value of AKI risk score[tissue inhibitor of metalloproteinase-2(TIMP-2)×insulin-like growth factor binding protein-7(IGFBP-7)levels]for mortality risk in critically ill patients.Methods A prospective observational study was conducted.The patients diagnosed with sepsis were admitted to the emergency departments of the First Affiliated Hospital of the University of Science and Technology of China and Peking Union Medical College Hospital from September 2021 to December 2022.Multivariate Logistic regression,Cox regression models,receiver operating characteristic(ROC)curve and area under ROC curve(AUC)were used to evaluate the predictive efficacy of the AKI risk score for in-hospital mortality risk.Subgroup analysis was conducted to evaluate the predictive value of the AKI risk score in the prognosis of different subgroups(AKI group and non-AKI group)patients based on whether the patient developed AKI.Results Data of 202 patients was available for this study,of which87 patients(43%)died during hospitalization.ROC of 6 h AKI risk score for predicting in-hospital mortality was 0.71(95%CI 0.63-0.78).Subgroup analysis showed that the AUC for predicting in-hospital mortality in the AKI group based on 6 h AKI risk score was 0.76(95%CI 0.65-0.85),while it was 0.63(95%CI 0.52-0.73)in the non-AKI group.Moreover,multivariable Logistic and Cox regression models indicated that the 6 h AKI risk score and AKI risk-gap were independent risk factors for in-hospital mortality.Conclusions The AKI risk score is a novel and reliable indicator to predict in-hospital mortality of patients with sepsis,especially 6 h AKI risk score for the patients with AKI,providing a reference for clinical differentiation of high-risk patients and appropriate treatment.