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Validation of the OAKS prognostic model for acute kidney injury after gastrointestinal surgery

STARSurg Collaborative and EuroSurg Collaborative ; Ahmed, W. U. R. ; Bhatia, S. ; [et al.]

Oxford University Press (OUP) ; 2022

In: BJS Open Vol. 6, No. 1 ( 2022-01-06)

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In: BJS Open, Oxford University Press (OUP), Vol. 6, No. 1 ( 2022-01-06)

Abstract: Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multicentre cohort studies. Methods The Outcomes After Kidney injury in Surgery (OAKS) prognostic model was developed to predict risk of AKI in the 7 days after surgery using six routine datapoints (age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker). Validation was performed within two independent cohorts: a prospective multicentre, international study (‘IMAGINE’) of patients undergoing elective colorectal surgery (2018); and a retrospective regional cohort study (‘Tayside’) in major abdominal surgery (2011–2015). Multivariable logistic regression was used to predict risk of AKI, with multiple imputation used to account for data missing at random. Prognostic accuracy was assessed for patients at high risk (greater than 20 per cent) of postoperative AKI. Results In the validation cohorts, 12.9 per cent of patients (661 of 5106) in IMAGINE and 14.7 per cent (106 of 719 patients) in Tayside developed 7-day postoperative AKI. Using the OAKS model, 558 patients (9.6 per cent) were classified as high risk. Less than 10 per cent of patients classified as low-risk developed AKI in either cohort (negative predictive value greater than 0.9). Upon external validation, the OAKS model retained an area under the receiver operating characteristic (AUC) curve of range 0.655–0.681 (Tayside 95 per cent c.i. 0.596 to 0.714; IMAGINE 95 per cent c.i. 0.659 to 0.703), sensitivity values range 0.323–0.352 (IMAGINE 95 per cent c.i. 0.281 to 0.368; Tayside 95 per cent c.i. 0.253 to 0.461), and specificity range 0.881–0.890 (Tayside 95 per cent c.i. 0.853 to 0.905; IMAGINE 95 per cent c.i. 0.881 to 0.899). Conclusion The OAKS prognostic model can identify patients who are not at high risk of postoperative AKI after gastrointestinal surgery with high specificity. Presented to Association of Surgeons in Training (ASiT) International Conference 2018 (Edinburgh, UK), European Society of Coloproctology (ESCP) International Conference 2018 (Nice, France), SARS (Society of Academic and Research Surgery) 2020 (Virtual, UK).

Type of Medium: Online Resource

ISSN: 2474-9842

URL: Article

DOI: 10.1093/bjsopen/zrab150

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2022

detail.hit.zdb_id: 2902033-5

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Impact of postoperative acute kidney injury in patients undergoing major gastrointestinal surgery on 1-year survival and renal outcomes: a national multicentre cohort study

STARSurg Collaborative ; McLean, Kenneth A ; Kamarajah, Sivesh K ; [et al.]

Oxford University Press (OUP) ; 2021

In: BJS Open Vol. 5, No. 6 ( 2021-11-09)

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In: BJS Open, Oxford University Press (OUP), Vol. 5, No. 6 ( 2021-11-09)

Abstract: The intermediate-term impact of acute kidney injury (AKI) in patients after major gastrointestinal and liver surgery has not been well characterized. This study aimed to evaluate the 1-year mortality rate and renal outcomes associated with postoperative AKI in a national prospective cohort. Methods This prospective multicentre, observational cohort with 1-year postoperative follow-up included adults undergoing major gastrointestinal and liver surgery across the UK and Ireland between 23 September and 18 November 2015. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. The primary outcome was death at 1-year after surgery, and the secondary outcome was Major Adverse Kidney Events (MAKE-365). Cox proportionate and multilevel logistic regression were used to account for case mix. Results Of 5745 patients across 173 centres, 1-year follow-up data was completed for 3504 patients (62.2 per cent, 126 centres), with attrition largely explained by centre non-participation (63.1 per cent). Some 13.6 per cent (475 of 3504) patients developed AKI by 7 days after surgery (stage 1: 9.2 per cent; stage 2/3: 4.3 per cent). At 1 year, 10.8 per cent (378 patients) experienced a MAKE-365 endpoint (303 patients had died, 61 had renal replacement therapy and 78 had renal dysfunction). Patients who experienced AKI by 7 days after surgery had a higher hazard of death at 1 year for KDIGO stage 1 (hazard ratio 1.50 (95 per cent c.i. 1.08 to 2.08), P = 0.016) and KDIGO stage 2/3 (hazard ratio 2.96 (95 per cent c.i. 2.02 to 4.33), P & lt; 0.001). Both KDIGO stage 1 (odds ratio 2.09 (95 per cent c.i. 1.50 to 2.92), P & lt; 0.001) and stage 2/3 (odds ratio 9.26 (95 per cent c.i. 6.31 to 13.59), P & lt; 0.001) AKI were independently associated with MAKE-365. Conclusion AKI events within 7 days after gastrointestinal or liver surgery are associated with significantly worse survival and renal outcomes at 1 year.

Type of Medium: Online Resource

ISSN: 2474-9842

URL: Article

DOI: 10.1093/bjsopen/zrab134

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2021

detail.hit.zdb_id: 2902033-5

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Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

STARSurg Collaborative ; McLean, K A ; Ahmed, W U R ; [et al.]

Oxford University Press (OUP) ; 2020

In: British Journal of Surgery Vol. 107, No. 8 ( 2020-06-15), p. 1023-1032

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In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 8 ( 2020-06-15), p. 1023-1032

Abstract: This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. Methods This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. Results A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). Conclusion There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Type of Medium: Online Resource

ISSN: 0007-1323 , 1365-2168

URL: Article

DOI: 10.1002/bjs.11453

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2020

detail.hit.zdb_id: 2006309-X

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Gold‐Triggered Uncaging Chemistry in Living Systems

Pérez‐López, Ana M. ; Rubio‐Ruiz, Belén ; Sebastián, Víctor ; [et al.]

Wiley ; 2017

In: Angewandte Chemie International Edition Vol. 56, No. 41 ( 2017-10-02), p. 12548-12552

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In: Angewandte Chemie International Edition, Wiley, Vol. 56, No. 41 ( 2017-10-02), p. 12548-12552

Abstract: Recent advances in bioorthogonal catalysis are increasing the capacity of researchers to manipulate the fate of molecules in complex biological systems. A bioorthogonal uncaging strategy is presented, which is triggered by heterogeneous gold catalysis and facilitates the activation of a structurally diverse range of therapeutics in cancer cell culture. Furthermore, this solid‐supported catalytic system enabled locally controlled release of a fluorescent dye into the brain of a zebrafish for the first time, offering a novel way to modulate the activity of bioorthogonal reagents in the most fragile and complex organs.

Type of Medium: Online Resource

ISSN: 1433-7851 , 1521-3773

URL: Issue

URL: Article

DOI: 10.1002/anie.v56.41

DOI: 10.1002/anie.201705609

RVK:

VA 2100

Language: English

Publisher: Wiley

Publication Date: 2017

detail.hit.zdb_id: 2011836-3

detail.hit.zdb_id: 123227-7

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Inside Back Cover: Gold‐Triggered Uncaging Chemistry in Living Systems (Angew. Chem. Int. Ed. 41/2017)

Pérez‐López, Ana M. ; Rubio‐Ruiz, Belén ; Sebastián, Víctor ; [et al.]

Wiley ; 2017

In: Angewandte Chemie International Edition Vol. 56, No. 41 ( 2017-10-02), p. 12789-12789

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In: Angewandte Chemie International Edition, Wiley, Vol. 56, No. 41 ( 2017-10-02), p. 12789-12789

Type of Medium: Online Resource

ISSN: 1433-7851 , 1521-3773

URL: Issue

URL: Article

DOI: 10.1002/anie.v56.41

DOI: 10.1002/anie.201708379

RVK:

VA 2100

Language: English

Publisher: Wiley

Publication Date: 2017

detail.hit.zdb_id: 2011836-3

detail.hit.zdb_id: 123227-7

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Gold‐Triggered Uncaging Chemistry in Living Systems

Pérez‐López, Ana M. ; Rubio‐Ruiz, Belén ; Sebastián, Víctor ; [et al.]

Wiley ; 2017

In: Angewandte Chemie Vol. 129, No. 41 ( 2017-10-02), p. 12722-12726

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In: Angewandte Chemie, Wiley, Vol. 129, No. 41 ( 2017-10-02), p. 12722-12726

Type of Medium: Online Resource

ISSN: 0044-8249 , 1521-3757

URL: Issue

URL: Article

DOI: 10.1002/ange.v129.41

DOI: 10.1002/ange.201705609

RVK:

VA 2100

RVK:

VN 5020

Language: English

Publisher: Wiley

Publication Date: 2017

detail.hit.zdb_id: 505868-5

detail.hit.zdb_id: 506609-8

detail.hit.zdb_id: 514305-6

detail.hit.zdb_id: 505872-7

detail.hit.zdb_id: 1479266-7

detail.hit.zdb_id: 505867-3

detail.hit.zdb_id: 506259-7

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Innenrücktitelbild: Gold‐Triggered Uncaging Chemistry in Living Systems (Angew. Chem. 41/2017)

Pérez‐López, Ana M. ; Rubio‐Ruiz, Belén ; Sebastián, Víctor ; [et al.]

Wiley ; 2017

In: Angewandte Chemie Vol. 129, No. 41 ( 2017-10-02), p. 12965-12965

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In: Angewandte Chemie, Wiley, Vol. 129, No. 41 ( 2017-10-02), p. 12965-12965

Type of Medium: Online Resource

ISSN: 0044-8249 , 1521-3757

URL: Issue

URL: Article

DOI: 10.1002/ange.v129.41

DOI: 10.1002/ange.201708379

RVK:

VA 2100

RVK:

VN 5020

Language: English

Publisher: Wiley

Publication Date: 2017

detail.hit.zdb_id: 505868-5

detail.hit.zdb_id: 506609-8

detail.hit.zdb_id: 514305-6

detail.hit.zdb_id: 505872-7

detail.hit.zdb_id: 1479266-7

detail.hit.zdb_id: 505867-3

detail.hit.zdb_id: 506259-7

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Counterintuitive Kinetics in Tsuji-Trost Allylation: Ion-Pair Partitioning and Implications for Asymmetric Catalysis

Evans, Louise A. ; Fey, Natalie ; Harvey, Jeremy N. ; [et al.]

American Chemical Society (ACS) ; 2008

In: Journal of the American Chemical Society Vol. 130, No. 44 ( 2008-11-05), p. 14471-14473

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In: Journal of the American Chemical Society, American Chemical Society (ACS), Vol. 130, No. 44 ( 2008-11-05), p. 14471-14473

Type of Medium: Online Resource

ISSN: 0002-7863 , 1520-5126

URL: Article

DOI: 10.1021/ja806278e

RVK:

VA 1120 ; VA 1752

Language: English

Publisher: American Chemical Society (ACS)

Publication Date: 2008

detail.hit.zdb_id: 1472210-0

detail.hit.zdb_id: 3155-0

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Expansion of the Ligand Knowledge Base for Chelating P,P-Donor Ligands (LKB-PP)

Jover, Jesús ; Fey, Natalie ; Harvey, Jeremy N. ; [et al.]

American Chemical Society (ACS) ; 2012

In: Organometallics Vol. 31, No. 15 ( 2012-08-13), p. 5302-5306

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In: Organometallics, American Chemical Society (ACS), Vol. 31, No. 15 ( 2012-08-13), p. 5302-5306

Type of Medium: Online Resource

ISSN: 0276-7333 , 1520-6041

URL: Article

DOI: 10.1021/om300312t

RVK:

VA 6293

Language: English

Publisher: American Chemical Society (ACS)

Publication Date: 2012

detail.hit.zdb_id: 2006302-7

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SHARPER Reaction Monitoring: Generation of a Narrow Linewidth NMR Singlet, without XPulses, in an Inhomogeneous Magnetic Field

Jones, Ariana B. ; Lloyd-Jones, Guy C. ; Uhrín, Dušan

American Chemical Society (ACS) ; 2017

In: Analytical Chemistry Vol. 89, No. 18 ( 2017-09-19), p. 10013-10021

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In: Analytical Chemistry, American Chemical Society (ACS), Vol. 89, No. 18 ( 2017-09-19), p. 10013-10021

Type of Medium: Online Resource

ISSN: 0003-2700 , 1520-6882

URL: Article

DOI: 10.1021/acs.analchem.7b02437

DOI: 10.1021/acs.analchem.7b02437.s001

Language: English

Publisher: American Chemical Society (ACS)

Publication Date: 2017

detail.hit.zdb_id: 1483443-1

detail.hit.zdb_id: 1508-8

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