Validation of the STARZ neonatal acute kidney injury risk stratification score
Title
Validation of the STARZ neonatal acute kidney injury risk stratification score
Creator
Sidharth Kumar Sethi
Rupesh Raina
Abhyuday Rana
Gopal Agrawal
Abhishek Tibrewal
Naveen Bajaj
Naveen Parkash Gupta
Shishir Mirgunde
Jagdish Sahoo
Binesh Balachandran
Kamran Afzal
Anubha Shrivastava
Jyoti Bagla
Sushma Krishnegowda
Ananth Konapur
Kritika Soni
Divya Sharma
Amrit Khooblall
Prajit Khooblall
Timothy Bunchman
Sanjay Wazir
Date
2022
Description
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 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: In 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, 0.910-0.954; p < 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, 20-40% for scores between 33 and 36, 40-60% for scores between 37 and 43, 60-80% 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. A higher resolution version of the Graphical abstract is available as Supplementary information.
Methods: The "Neonatal AKI Risk Prediction Scoring" was devised as the "STARZ [Sethi, Tibrewal, Agrawal, Raina, waZir]" Score. The STARZ score was 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: In 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, 0.910-0.954; p < 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, 20-40% for scores between 33 and 36, 40-60% for scores between 37 and 43, 60-80% 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. A higher resolution version of the Graphical abstract is available as Supplementary information.
Source
Pediatr Nephrol
. 2022 Aug;37(8):1923-1932. doi: 10.1007/s00467-021-05369-1. Epub 2022 Jan 12.
. 2022 Aug;37(8):1923-1932. doi: 10.1007/s00467-021-05369-1. Epub 2022 Jan 12.
Language
English
URL
https://doi.org/10.1007/s00467-021-05369-1
Citation
Sidharth Kumar Sethi et al., “Validation of the STARZ neonatal acute kidney injury risk stratification score,” NEOMED Bibliography Database, accessed April 16, 2024, https://neomed.omeka.net/items/show/12108.