A new parameter in predicting contrast-induced nephropathy: Osaka prognostic score

Özbeyaz, Nail Burak; Algül, Engin

doi:10.1590/1806-9282.20240423

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Revista da Associação Médica Brasileira

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Sumário

Original Article • Rev. Assoc. Med. Bras. 70 (7) • 2024 • https://doi.org/10.1590/1806-9282.20240423 copy

A new parameter in predicting contrast-induced nephropathy: Osaka prognostic score

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

Nowadays, the frequency of complications is also increasing following the increasing frequency of coronary angiography and percutaneous coronary intervention. Contrast-induced nephropathy is one of the most common of these complications. This study aimed to investigate the relationship between the Osaka prognostic score, which has previously been shown to have prognostic importance in gastrointestinal malignancies, and the development of contrast-induced nephropathy.

METHODS:

The study retrospectively examined the data of 1,498 patients who underwent coronary angiography and percutaneous coronary intervention due to acute coronary syndrome between 2018 and 2023. Demographic characteristics and laboratory findings were retrospectively collected from patients’ charts and electronic medical records.

RESULTS:

Osaka prognostic score (0.84±0.25 vs. 2.2±0.32, p<0.001) was higher in patients who developed contrast-induced nephropathy. Also, Osaka prognostic score [OR 2.161 95%CI (1.101–4.241), p<0.001] was found to be an independent risk factor along with age, diabetes mellitus, systolic pulmonary artery pressure, hemoglobin, hemoglobin, C-reactive protein, albumin, N-terminal brain natriuretic peptide, and systemic immune-inflammation index. The receiver operating characteristic curve showed that the optimal cutoff value of Osaka prognostic score to predict the development of contrast-induced nephropathy was 1.5, with a sensitivity of 83.4 and a specificity of 65.9% [area under the curve: 0.874 (95%CI: 0.850–0.897, p≤0.001)].

CONCLUSION:

Osaka prognostic score may be an easily calculable, user-friendly, and useful parameter to predict the development of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention after acute coronary syndromes.

KEYWORDS:
Osaka prognostic score; Inflammation; Nutrition; Contrast-induced nephropathy; Acute coronary syndrome; Percutaneous coronary intervention

		Non-CIN group, n=1242	CIN group, n=256	p-value
Demographics
	Age, years	58.6±12.1	64.1±13.0	<0.001
	Male gender, n (%)	673 (54.1)	148 (57.8)	0.004
	Diabetes mellitus, n (%)	381 (30.8)	160 (62.7)	0.001
	Hypertension, n (%)	545 (44.0)	165 (64.5)	<0.001
	Hyperlipidemia, n (%)	758 (61.0)	169 (66.0)	0.138
	CAD, n (%)	474 (38.2)	108 (42.7)	0.203
	HF, n (%)	920 (74.1)	209 (81.6)	0.011
	Smoking, n (%)	381 (30.7)	81 (31.8)	0.211
	BMI, kg/m²	27.9±7.5	27.6±5.6	0.819
On admission, clinical characteristics
	Systolic blood pressure, mmHg	135.7±39.6	135.9±36.1	0.340
	Heart rate, per minute	79.6±19.2	82.9±22.1	0.449
	Left-ventricular ejection fraction (%)	42.9±10.5	40.3±10.6	0.542
	sPAP, mmHg	35.0±7.8	39.2±8.4	0.004
MI type
	Anterior MI	300 (24.2)	114 (44.5)	0.001
	Inferior MI	405 (32.6)	56 (21.9)
	NSTEMI	537 (43.2)	86 (33.6)
Laboratory results
	Hemoglobin, g/dL	14.1±4.9	13.8±5.7	0.040
	White blood cell count, cells/μL	10.5±4.9	10.8±5.6	0.732
	Lymphocyte count, 10⁹/L	1.6±0.3	1.5±0.2	<0.001
	Platelet count, cells/μL	260.7±82.6	251.5±89.1	0.207
	CRP, mg/L	7.5±3.2	12.4±2.8	0.009
	Albumin, g/dL	3.7±0.5	3.2±0.6	<0.001
	Admission blood glucose, mg/dL	161.8±85.2	187.6±96.7	0.001
	Baseline creatinine, mg/dL	1.2±0.9	1.3±1.0	0.076
	Peak creatinine, mg/dL	1.4±1.1	1.8±1.2	0.003
	Peak creatinine kinase–myocardial band, ng/mL	70.8±21.2	117.6±18.8	0.390
	Peak troponin, ng/L	10562±531	11538±413	0.574
	NT-proBNP, pg/dL	2056±787	2935±766	0.013
	Total cholesterol, mg/dL	185.3±23.9	171.1±22.4	0.223
	TG, mg/dL	180.8±28.5	182.9±23.6	0.071
	HDL, mg/dL	39.1±12.5	39.9±16.8	0.109
	LDL, mg/dL	126.0±36.3	122.1±33.8	0.273
Angiographic and clinical data
	Multi-vessel stenosis (>50%), n (%)	360 (29.0)	61 (23.8)	0.109
	LAD as the infarct-related artery, n (%)	608 (49.0)	163 (63.7)	0.001
	Contrast volume, mL	274.1±61.0	273.2±58.2	0.764
	Need for dialysis, n (%)	0 (0)	30 (11.7)	<0.001
	Length of hospital stay, days	6.4±5.1	8.8±4.6	0.012
	In-hospital mortality	34 (2.7)	24 (9.4)	<0.001
	OPS	0.84±0.25	2.2±0.32	<0.001
	GPS	0.42±0.15	1.46±0.13	0.025
	PNI	44.9±4.7	39.1±6.4	0.001
	SII	981.2±114.4	1177.9±111.8	0.008

	Univariate analysis	p-value	Multivariate analysis	p-value
	OR (95%CI)	p-value	OR (95%CI)	p-value
Age	1.059 (1.047–1.070)	<0.001	1.046 (1.025–1.067)	0.001
Male gender	2.406 (1.817–3.186)	0.001	1.010 (0.610–1.1671)	0.970
Diabetes mellitus	3.793 (2.2863–5.024)	0.001	2.605 (1.612–4.210)	0.001
Hypertension	2.3112 (1.749–3.058)	<0.001	1.615 (0.985–2.650)	0.058
HF	1.556 (1.107–2.189)	0.011	1.659 (0.957–2.874)	0.071
sPAP	1.056 (1.041–1.072)	0.003	1.050 (1.026–1.074)	0.001
Anterior MI	3.008 (1.652–5.476)	0.001	2.521 (1.908–3.331)	0.001
Hemoglobin count	0.822 (0.774–0.873)	<0.001	0.913 (0.834–0.998)	0.046
Lymphocyte count	0.050 (0.024–0.103)	<0.001	0.109 (0.018–0.653)	<0.001
CRP	1.544 (1.465–1.628)	<0.001	1.479 (1.339–1.634)	<0.001
Albumin	0.167 (0.127–0.220)	0.001	0.256 (0.142–0.462)	0.001
Admission blood glucose	1.003 (1.002–1.004)	0.001	0.999 (0.997–1.002)	0.642
NT-proBNP	1.001 (1.001–1.002)	<0.001	1.001 (1.001–1.002)	0.001
LAD as the infarct-related artery	1.828 (1.384–2.413)	<0.001	0.942 (0.545–1.629)	0.832
OPS	8.128 (6.349–9.405)	<0.001	2.161 (1.101–4.241)	<0.001
GPS	5.441 (3.972–8.676)	0.004	1.098 (0.449–2.686)	0.838
PNI	0.825 (0.802–0.848)	<0.001	0.806 (0.782–1.004)	0.569
SII	1.002 (1.001–1.003)	0.001	1.001 (1.001–1.002)	0.001

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[1] *Corresponding author:
drozbeyaz@gmail.com