Performance of a Pre-Procedural Mehran Score to Predict Acute Kidney Injury After Percutaneous Coronary Intervention

Acute kidney injury (AKI) is a known complication of patients undergoing cardiac catherization or Percutaneous Coronary Interventions (PCI), affecting up to 14% of patients, and is associated with increased overall mortality and risk of cardiac events. The Mehran score was developed to identify patients that are at risk for AKI after cardiac catheterization or PCI, but its use of contrast volume as part of the score calculation limits its application prior to the procedure. In this study, we evaluated the utility of a modified Mehran score that utilizes only pre-procedural data by excluding contrast volume. This was done in a retrospective fashion using data from patients who received PCI at our institution between July 2015 and December 2017 by evaluating the discriminative ability of the scoring systems for predicting outcomes through a receiver-operator characteristic curve analysis. We found that, despite a small loss in discrimination, there was no difference in the four-category net discrimination index between the two scores. The pre-procedural modified Mehran score is a useful clinical predictor of the risk of AKI in patients undergoing PCI with a sensitivity of 95% for the low risk group and specificity of 96% for the high-risk group. Due to the readily available risk score components it allows for immediate identification of high-risk patients prior to PCI and application of renal protective measures prior to the procedure at an appropriate and timely manner