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Predicting contrast-induced nephropathy after CT pulmonary angiography in the critically ill: a retrospective cohort study

Overview of attention for article published in Journal of Intensive Care, January 2018
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Title
Predicting contrast-induced nephropathy after CT pulmonary angiography in the critically ill: a retrospective cohort study
Published in
Journal of Intensive Care, January 2018
DOI 10.1186/s40560-018-0274-z
Pubmed ID
Authors

Kwok M. Ho, Yusrah Harahsheh

Abstract

It is uncertain whether we can predict contrast-induced nephropathy (CIN) after CT pulmonary angiography (CTPA). This study compared the ability of a validated CIN prediction score with the Pulmonary Embolism Severity Index (PESI) in predicting CIN after CTPA. This cohort study involved critically ill adult patients who required a CTPA to exclude acute pulmonary embolism (PE). Patients with end-stage renal failure requiring dialysis were excluded. CIN was defined as an elevation in plasma creatinine concentrations > 44.2μmol/l (or 0.5 mg/dl) within 48 h after CTPA. Of the 137 patients included, 77 (51%) were hypotensive, 54 (39%) required inotropic support, and 68 (50%) were mechanically ventilated prior to the CTPA. Acute PE was confirmed in 21 patients (15%) with 14 (10%) being bilateral. CIN occurred in 56 patients (41%) with 35 (26%) required dialysis subsequent to CTPA. The CIN prediction score had a good ability to discriminate between patients with and without developing CIN (Area under the receiver-operating-characteristic (AUROC) curve 0.864, 95% confidence interval [CI] 0.795-0.916) and requiring subsequent dialysis (AUROC 0.897, 95% CI 0.833-0.942) and was better than the PESI in predicting both outcomes (AUROC 0.731, 95% CI 0.649-0.804 and 0.775, 95% CI 0.696-0.842, respectively). A CIN risk score > 10 and 12 had an 82.1 and 85.7% sensitivity and 81.5 and 78.4% specificity to predict subsequent CIN and dialysis, respectively. The CIN prediction model tended to underestimate the observed risks of dialysis, but this was improved after recalibrating the slope and intercept of the original prediction equation. The CIN prediction score had a good ability to discriminate between critically ill patients with and without developing CIN after CTPA. Used together for critically ill patients with suspected acute PE, the CIN prediction score and PESI may be useful to inform clinicians when the benefits of a CTPA scan will outweigh its potential harms.

Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 24%
Student > Master 3 14%
Student > Bachelor 3 14%
Unspecified 2 10%
Other 2 10%
Other 2 10%
Unknown 4 19%
Readers by discipline Count As %
Medicine and Dentistry 11 52%
Unspecified 2 10%
Pharmacology, Toxicology and Pharmaceutical Science 1 5%
Biochemistry, Genetics and Molecular Biology 1 5%
Engineering 1 5%
Other 0 0%
Unknown 5 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 February 2018.
All research outputs
#11,066,831
of 12,448,635 outputs
Outputs from Journal of Intensive Care
#250
of 271 outputs
Outputs of similar age
#289,875
of 342,651 outputs
Outputs of similar age from Journal of Intensive Care
#14
of 15 outputs
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We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.