{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T15:10:10Z","timestamp":1758899410480,"version":"3.44.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases-National Science and Technology","award":["2025ZD0547500","2025ZD0547501"],"award-info":[{"award-number":["2025ZD0547500","2025ZD0547501"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology","award":["2025ZD0546700","2025ZD0546704","2025ZD0546703"],"award-info":[{"award-number":["2025ZD0546700","2025ZD0546704","2025ZD0546703"]}]},{"name":"Fuwai Hospital"},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","award":["2022-GSP-GG-28"],"award-info":[{"award-number":["2022-GSP-GG-28"]}],"id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81830072"],"award-info":[{"award-number":["81830072"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Science and Technology of People\u2019s Republic of China","award":["2016YFC1302000"],"award-info":[{"award-number":["2016YFC1302000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Early prediction is crucial for cardiac surgery-associated acute kidney injury (CSA-AKI). We aimed to develop and validate a simple, clinical- and laboratory-based risk score system for better CSA-AKI prediction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a new pre-operative risk score system for moderate-to-severe CSA-AKI in a 10-year cohort of patients undergoing coronary artery bypass grafting at one tertiary centre. Most predictive laboratory and clinical variables were identified and constituted a simple and a full model. External testing was performed in patients at another centre. The risk score system was compared with 2 established clinical models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall cohort comprised 27\u00a0534, 6403, and 1733 patients with moderate-to-severe CSA-AKI rates of 3.3%, 2.8%, and 8.4% for training, validation, and external testing, respectively. A simple 6-variable AB2C-S2 score (Age, Biomarkers of N-terminal pro-B-type natriuretic peptide and haemoglobin, Clinical history of preoperative critical state, Surgical factors of isolated surgery and on-pump surgery) and a full 9-variable AB2C2-S4 score (AB2C-S2 score plus hypertension, urgent surgery, and previous surgery) were developed. The simple model achieved similar performance as the full model in validation (area under the receiver-operating characteristic curve [AUC] 0.78 vs 0.79, P\u2009=\u2009.37) and external testing (AUC 0.74 vs 0.75, P\u2009=\u2009.17), and both significantly outperformed than 2 established clinical models: Cleveland Clinic model (validation: AUC 0.71, external testing: AUC 0.65, all P\u2009&amp;lt;\u2009.001) and Ng model (validation: AUC 0.64, external testing: AUC 0.65, all P\u2009&amp;lt;\u2009.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A simple preoperative risk score system for moderate-to-severe CSA-AKI was developed and outperformed established complex clinical models.<\/jats:p>\n               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100006, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1235-3180","authenticated-orcid":false,"given":"Juntong","family":"Zeng","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, 100006, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shen","family":"Lin","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, 100006, People\u2019s Republic of","place":["China"]},{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Key Laboratory of Coronary Heart Disease Risk Prediction and Precision Therapy, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, 100037, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongchen","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, 100006, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohong","family":"Huang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, 100006, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Key Laboratory of Coronary Heart Disease Risk Prediction and Precision Therapy, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, 100037, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-7178","authenticated-orcid":false,"given":"Sheng","family":"Liu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing, 100006, People\u2019s Republic of","place":["China"]},{"name":"Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing, 100037, People\u2019s Republic of","place":["China"]},{"name":"Key Laboratory of Coronary Heart Disease Risk Prediction and Precision Therapy, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, 100037, People\u2019s Republic of","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9162-6492","authenticated-orcid":false,"given":"Zhe","family":"Zheng","sequence":"additional","affiliation":[{"name":"National Clinical 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