Perioperative medicine & outcomes
External Validation of the Simple Postoperative Acute Kidney Injury Risk Index in Patients Admitted to the Intensive Care Unit After Noncardiac Surgery
Authors' conclusion
The SPARK index showed fair discrimination and calibration among patients admitted to the ICU after noncardiac surgery. Modification of the model improved the performance of the model in terms of predicting PO-AKI.
Study context
- Population
- High-risk patients requiring intensive care unit (ICU) care after noncardiac surgery
- Participants
- 973 patients
- Outcome
- PO-AKI (sCr increase ≥26.5 mmol/L within 48 hours or 150% vs preoperative baseline within 7 days after surgery)
Methodological detailsexternal validation of a prediction model, single-center
- External validation of a prediction model
- Single-center
Main finding
As reported in the abstract
Discrimination of the SPARK index (AUC)
- AUC for postoperative acute kidney injury (PO-AKI)
- 0.703 (95% CI, 0.641-0.765)
- AUC for critical AKI
- 0.699 (95% CI, 0.550-0.848)
- Sensitivity for PO-AKI (10% predicted probability threshold)
- 68.35%
- Specificity for PO-AKI (10% predicted probability threshold)
- 57.49%
- NPV for PO-AKI (10% predicted probability threshold)
- 95.36%
- PPV for PO-AKI (10% predicted probability threshold)
- 12.44%
Observational data: associations, not effects.
Further findings
Incidence of PO-AKI and critical AKI
- PO-AKI
- 79 (8.1%)
- Critical AKI
- 14 (1.4%)
- PO-AKI incidence, lowest to highest Simple Postoperative AKI Risk (SPARK) risk group
- 2.56% to 25.64%
- Allocated in highest risk group, this cohort vs SPARK discovery cohort
- 8.02% vs 1.20%
Modified model (refitted coefficients), AUC for PO-AKI
- Significantly improved AUC for PO-AKI on external validation after model modification
Original publication
External Validation of the Simple Postoperative Acute Kidney Injury Risk Index in Patients Admitted to the Intensive Care Unit After Noncardiac Surgery. Anesth Analg. Published 1 May 2025. doi:10.
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