ACCURACY OF MEHRAN SCORING IN PREDICTING AKI AMONG PATIENTS UNDERGOING NON-CARDIAC CT SCAN IN MCU-FDTMF HOSPITAL

 

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https://storage.unitedwebnetwork.com/files/1099/30af78e016220869a791ce3444916930.pdf
ACCURACY OF MEHRAN SCORING IN PREDICTING AKI AMONG PATIENTS UNDERGOING NON-CARDIAC CT SCAN IN MCU-FDTMF HOSPITAL

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Michael Nevenilius
Perez
Michael Nevenilius Perez mike_neve_perez@yahoo.com Manila Central University Section of Adult Nephrology Quezon City Philippines *
Bea Barbara Carrascal bbccarrascal@gmail.com Manila Central University Section of Adult Nephrology Quezon City Philippines -
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Background. Contrast-induced acute kidney injury (CI-AKI) is a leading cause of hospital-acquired kidney injury, particularly in patients exposed to contrast media during diagnostic procedures. While several risk stratification tools exist, the Mehran Risk Scoring System remains the most widely used and validated model for predicting CI-AKI in cardiac-related interventions. 

Objectives. This study aimed to determine the accuracy of Mehran Risk Scoring (MRS) for contrast induced nephropathy in patients who underwent Non-Cardiac Related Contrast Media Studies. Specifically, it sought to describe the respondents’ clinical and demographic characteristics and also aimed to determine the period prevalence of CI-AKI post CECT, compute the Mehran risk scores for these patients, and evaluate the scoring system’s predictive accuracy in terms of sensitivity and specificity.

Methods. This study utilized a retrospective cohort design, wherein data from admitted patients who underwent non-cardiac contrast-enhanced imaging procedures over a 10-year period were reviewed and analyzed. Eligible patients included primarily adults with no prior diagnosis of AKI, and who had both baseline and follow-up serum creatinine measurements. Descriptive statistics were used to summarize the characteristics of the participants. The discriminatory ability of the Mehran Scoring system to predict AKI was evaluated using a Receiver Operating Characteristic (ROC) curve. Diagnostic metrics were computed to assess the performance of the scoring system in detecting AKI.

Results. Across 526 contrast-enhanced CT examinations, CI-AKI occurred in 6.8%, with early peaks around 13% (2015-2016) dropping to 2.9% by 2024. Patients were evenly split by sex, typically middle-aged (median 56 years), and largely preserved renal function (median eGFR ≈ 99). Hypertension and diabetes were common, while severe heart failure, hypotension, and hypoalbuminemia were less frequent but concentrated in higher Mehran risk strata. Most cases (78%) were low-risk per Mehran Score; no patients reached “very-high” risk. A cutoff of ≥5.5 yielded excellent diagnostic performance (sensitivity 97%, specificity 83%, AUC 0.94). , establishing the score’s utility—particularly as a powerful rule-out tool for CI-AKI.

Conclusion. Based on these results, the MRS system demonstrated excellent predictive accuracy for CI-AKI in patients undergoing non-cardiac contrast-enhance CT at our hospital. With high sensitivity and specificity, and an AUC of 0.94, the scoring system proved to be a valuable diagnostic tool, particularly effective in ruling out CI-AKI at a threshold of <5.5. This affirms the potential utility of Mehran Scoring beyond cardiac procedures and supports its application in broader clinical settings to enhance patient safety and risk stratification.

Kewords