title: Risk prediction models for acute kidney injury following major noncardiac surgery: systematic review.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a serious complication of major noncardiac surgery. Risk prediction models for AKI following noncardiac surgery may be useful for identifying high-risk patients to target with prevention strategies.
  
  
  METHODS
  We conducted a systematic review of risk prediction models for AKI following major noncardiac surgery. MEDLINE, EMBASE, BIOSIS Previews and Web of Science were searched for articles that (i) developed or validated a prediction model for AKI following major noncardiac surgery or (ii) assessed the impact of a model for predicting AKI following major noncardiac surgery that has been implemented in a clinical setting.
  
  
  RESULTS
  We identified seven models from six articles that described a risk prediction model for AKI following major noncardiac surgeries. Three studies developed prediction models for AKI requiring renal replacement therapy following liver transplantation, three derived prediction models for AKI based on the Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE) criteria following liver resection and one study developed a prediction model for AKI following major noncardiac surgical procedures. The final models included between 4 and 11 independent variables, and c-statistics ranged from 0.79 to 0.90. None of the models were externally validated.
  
  
  CONCLUSIONS
  Risk prediction models for AKI after major noncardiac surgery are available; however, these models lack validation, studies of clinical implementation and impact analyses. Further research is needed to develop, validate and study the clinical impact of such models before broad clinical uptake.
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
authors.forename: Todd
authors.initials: T
authors.lastname: Wilson
authors.affiliation: Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Samuel
authors.initials: S
authors.lastname: Quan
authors.affiliation: Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Cheema
authors.affiliation: Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Zarnke
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Rob
authors.initials: R
authors.lastname: Quinn
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: de Koning
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Department of Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Neesh
authors.initials: N
authors.lastname: Pannu
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Department of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: James
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D008962:Models, Theoretical; D011183:Postoperative Complications; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
keywords: acute kidney injury; noncardiac surgery; risk prediction model; systematic review; validation