Scholarlink

Objective <p>This study explored the incidence and risk factors of acute kidney injury (AKI) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow septal myectomy and developed a risk prediction model to optimize perioperative management.</p> Methods <p>A retrospective cohort of HOCM patients who underwent modified Morrow procedure between 2012 and 2024 was analyzed. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria, and patients were grouped into AKI and non-AKI cohorts. Univariate analysis followed by binary logistic regression identified independent predictors of AKI, which informed the development of a nomogram-based prediction model. Model performance was assessed using the concordance index (C-index), calibration curves, and decision curve analysis.</p> Results <p>Among 270 patients, 54 (20%) developed AKI, including 24, 12, and 18 patients classified as stage 1, stage 2, and stage 3 respectively, with 15 requiring hemodialysis. Independent predictors included preoperative creatinine (OR = 1.069, <i>P</i> &lt; 0.001), postoperative 48-h alanine aminotransferase (ALT) (OR = 1.001, <i>P</i> = 0.021), total bilirubin (TBIL) (OR = 1.036, <i>P</i> = 0.015), pulmonary infection (OR = 9.432, <i>P</i> &lt; 0.001), and red blood cell transfusion (OR = 1.246, <i>P</i> = 0.002). The logistic model achieved 81.13% sensitivity, 87.91% specificity, and an AUC of 0.904 (95% CI: 0.862 ~ 0.936). The nomogram showed excellent accuracy, with a C-index of 0.890.</p> Conclusion <p>AKI is a frequent and severe complication after modified Morrow myectomy in HOCM. Identifying high-risk patients and addressing modifiable factors may improve perioperative management and outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Nomogram prediction of acute kidney injury following modified Morrow myectomy in hypertrophic obstructive cardiomyopathy: insights from 12 years of outcomes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月30日

查看全文
  • Xiaodong Zeng,
  • Yuemei Liang ,
  • Yijin Wu,
  • Hongxiang Wu,
  • Ruobing Wang,
  • Pingchuan Huang,
  • Xuan Xu ,
  • Ying Zeng,
  • Minjie Huang ,
  • Xinze Song ,
  • Jimei Chen ,
  • Liming Lei ,
  • Huiming Guo

摘要

Objective

This study explored the incidence and risk factors of acute kidney injury (AKI) in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing modified Morrow septal myectomy and developed a risk prediction model to optimize perioperative management.

Methods

A retrospective cohort of HOCM patients who underwent modified Morrow procedure between 2012 and 2024 was analyzed. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria, and patients were grouped into AKI and non-AKI cohorts. Univariate analysis followed by binary logistic regression identified independent predictors of AKI, which informed the development of a nomogram-based prediction model. Model performance was assessed using the concordance index (C-index), calibration curves, and decision curve analysis.

Results

Among 270 patients, 54 (20%) developed AKI, including 24, 12, and 18 patients classified as stage 1, stage 2, and stage 3 respectively, with 15 requiring hemodialysis. Independent predictors included preoperative creatinine (OR = 1.069, P < 0.001), postoperative 48-h alanine aminotransferase (ALT) (OR = 1.001, P = 0.021), total bilirubin (TBIL) (OR = 1.036, P = 0.015), pulmonary infection (OR = 9.432, P < 0.001), and red blood cell transfusion (OR = 1.246, P = 0.002). The logistic model achieved 81.13% sensitivity, 87.91% specificity, and an AUC of 0.904 (95% CI: 0.862 ~ 0.936). The nomogram showed excellent accuracy, with a C-index of 0.890.

Conclusion

AKI is a frequent and severe complication after modified Morrow myectomy in HOCM. Identifying high-risk patients and addressing modifiable factors may improve perioperative management and outcomes.