Neonatal AKI is Common in Neonatal Intensive Care Units & Leads to Worse Outcomes, Treatment by Dr. Sidharth Kumar Sethi

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Neonatal AKI is Common in Neonatal Intensive
Care Units Leads to Worse Outcomes, Treatment
by Dr. Sidharth Kumar Sethi
Background Neonatal acute kidney injury (AKI) is
common in neonatal intensive care units (NICU)
and leads to worse outcomes. Stratifying
neonates into an at risk category allows
health care providers to objectively recognize
opportunities for improvements in quality of
care. Methods The Neonatal AKI Risk Prediction
Scoring was devised as the STARZ Sethi,
Tibrewal, Agrawal, Raina, waZir Score. The
STARZ score was
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derived from our prior multicentre study
analysing risk factors for AKI in neonates
admitted to the NICU. This tool includes 10
variables with a total score ranging from 0 to
100 and a cut-off score of 31.5. In the present
study, the scoring model has been validated in
our multicentre cohort of 744 neonates. Results I
n the validation cohort, this scoring model had
sensitivity of 82.1, specificity 91.7, positive
predictive value 81.2, negative predictive
value 92.2 and accuracy 88.8. Based on the
STARZ cut-off score of 31.5, an area under the
receiver operating characteristic (ROC) curve
was observed
to be 0.932 (95 CI, 0.9100.954 p
lt 0.001)
signifying that the discriminative power was high.
In the validation cohort, the probability of AKI
was
less than 20 for scores up to 32, 2040 for
scores between 33 and 36, 4060 for scores
between 37 and 43, 6080 for scores between 44
and 49, and 80 for scores 50.
Conclusions
To promote the survival of susceptible neonates,
early detection and prompt interventional
measures based on highly evidenced research is
vital. The risk of AKI in admitted neonates can
be quantitatively determined by the rapid STARZ
scoring system.