Development of real-time individualized risk prediction models for contrast associated acute kidney injury and 30-day dialysis after contrast enhanced computed tomography

doi:10.1016/j.ejrad.2023.111034

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Title:	Development of real-time individualized risk prediction models for contrast associated acute kidney injury and 30-day dialysis after contrast enhanced computed tomography
Authors:	Chen, Yen-Yu Liu, Chung-Feng Shen, Yu-Ting Kuo, Yu-Ting Ko, Ching-Chung Chen, Tai-Yuan Wu, Te-Chang Shih, Yun-Ju
Contributors:	Chi Mei Med Ctr, Dept Med Imaging Chi Mei Med Ctr, Dept Med Res Kaohsiung Med Univ, Coll Med, Dept Med Natl Sun Yat Sen Univ, Inst Precis Med, Coll Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chang Jung Christian Univ, Grad Inst Med Sci Chang Jung Christian Univ, Dept Med Sci Ind Chang Jung Christian Univ, Dept Nursing
Keywords:	Contrast-associated acute kidney injury Contrast-enhanced computed tomography Dialysis Risk prediction Artificial intelligence Machine learning
Date:	2023
Issue Date:	2024-12-25 11:04:25 (UTC+8)
Publisher:	ELSEVIER IRELAND LTD
Abstract:	Purpose: This study aimed to develop preprocedural real-time artificial intelligence (AI)-based systems for predicting individualized risks of contrast-associated acute kidney injury (CA-AKI) and dialysis requirement within 30 days following contrast-enhanced computed tomography (CECT).Method: This single-center, retrospective study analyzed adult patients from emergency or in-patient departments who underwent CECT; 18,895 patients were included after excluding those who were already on dialysis, had stage V chronic kidney disease, or had missing data regarding serum creatinine levels within 7 days before and after CECT. Clinical parameters, laboratory data, medication exposure, and comorbid diseases were selected as predictive features. The patients were randomly divided into model training and testing groups at a 7:3 ratio. Logistic regression (LR) and random forest (RF) were employed to create prediction models, which were evaluated using receiver operating characteristic curves.Results: The incidence rates of CA-AKI and dialysis within 30 days post-CECT were 6.69% and 0.98%, respectively. For CA-AKI prediction, LR and RF exhibited similar performance, with areas under curve (AUCs) of 0.769 and 0.757, respectively. For 30-day dialysis prediction, LR (AUC, 0.863) and RF (AUC, 0.872) also exhibited similar performance. Relative to eGFR-alone, the LR and RF models produced significantly higher AUCs for CAAKI prediction (LR vs. eGFR alone, 0.769 vs. 0.626, p < 0.001) and 30-day dialysis prediction (RF vs. eGFR alone, 0.872 vs. 0.738, p < 0.001).Conclusions: The proposed AI prediction models significantly outperformed eGFR-alone for predicting the CA-AKI and 30-day dialysis risks of emergency department and hospitalized patients who underwent CECT.
Relation:	European Journal of Radiology, v.167, Article 111034
Appears in Collections:	[Offices] 456

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