ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
A web-based machine-learning algorithm predicting postoperative acute kidney injury after total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 6 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 6 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Artificial intelligence in total and unicompartmental knee arthroplasty.BMC musculoskeletal disorders · 2024Pooled it
- Prediction of Complications and Prognostication in Perioperative Medicine: A Systematic Review and PROBAST Assessment of Machine Learning Tools.Anesthesiology · 2024Pooled it
- Characterization of Risk Prediction Models for Acute Kidney Injury: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Artificial intelligence for the prediction of acute kidney injury during the perioperative period: systematic review and Meta-analysis of diagnostic test accuracy.BMC nephrology · 2022Pooled it
- Machine learning in knee arthroplasty: specific data are key-a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Availability and reporting quality of external validations of machine-learning prediction models with orthopedic surgical outcomes: a systematic review.Acta orthopaedica · 2021Pooled it
- Joint-specific measures improve risk adjustment in total knee arthroplasty: A machine learning approach.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Spinal Versus General Anesthesia for Acute Kidney Injury and Transfusion in One-Week-Staged Bilateral Total Knee Arthroplasty.Journal of clinical medicine · 2026Article
- Systematic Review and Meta-Analysis of Machine Learning Models for Acute Kidney Injury Risk Classification.Journal of the American Society of Nephrology : JASN · 2025Article
- Artificial intelligence for electrocardiographic diagnosis of perioperative myocardial ischaemia: a scoping review.British journal of anaesthesia · 2025Article
- Postoperative mid-to-long-term adverse event prediction model for patients receiving non-cardiac surgery: An extension of the Simple Postoperative AKI RisK (SPARK) model.Clinical kidney journal · 2025Article
- Machine Learning to Assist in Managing Acute Kidney Injury in General Wards: Multicenter Retrospective Study.Journal of medical Internet research · 2025Article
- Development and validation of a predictive model for acute kidney injury in patients with ureterolithiasis.Renal failure · 2024Article
- Machine learning approaches toward an understanding of acute kidney injury: current trends and future directions.The Korean journal of internal medicine · 2024Review
- A simple machine learning model for the prediction of acute kidney injury following noncardiac surgery in geriatric patients: a prospective cohort study.BMC geriatrics · 2024Article
- Total Knee Arthroplasty: Is It Safe? A Single-Center Study of 4,124 Patients in South Korea.Clinics in orthopedic surgery · 2023Article
- Artificial intelligence and telemedicine in the field of anaesthesiology, intensive care and pain medicine: A European survey.European journal of anaesthesiology and intensive care · 2023Article
- Prediction of complications and surgery duration in primary TKA with high accuracy using machine learning with arthroplasty-specific data.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Construction and Validation of a Nomogram for Predicting Acute Kidney Injury After Hip Fracture Surgery.Clinical interventions in aging · 2023Article
- Artificial Intelligence and Machine Learning in Perioperative Acute Kidney Injury.Advances in kidney disease and health · 2023Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeAcute kidney injury (AKI) is a deleterious complication after total knee arthroplasty (TKA). The purposes of this study were to identify preoperative risk factors and develop a web-based prediction model for postoperative AKI, and assess how AKI affected the progression to ESRD.
methodThe study included 5757 patients treated in three tertiary teaching hospitals. The model was developed using data on 5302 patients from two hospitals and externally validated in 455 patients from the third hospital. Eighteen preoperative variables were collected and feature selection was performed. A gradient boosting machine (GBM) was used to predict AKI. A tenfold-stratified area under the curve (AUC) served as the metric for internal validation. Calibration was performed via isotonic regression and evaluated using a calibration plot. End-stage renal disease (ESRD) was followed up for an average of 41.7 months.
resultsAKI develops in up to 10% of patients undergoing TKA, increasing the risk of progression to ESRD. The ESRD odds ratio of AKI patients (compared to non-AKI patients) was 9.8 (95% confidence interval 4.3-22.4). Six key predictors of postoperative AKI were selected: higher preoperative levels of creatinine in serum, the use of general anesthesia, male sex, a higher ASA class (> 3), use of a renin-angiotensin-aldosterone system inhibitor, and no use of tranexamic acid (all p < 0.001). The predictive performance of our model was good (area under the curve 0.78 [95% CI 0.74-0.81] in the developmental cohort and improved in the external validation cohort (0.89). Our model can be accessed at https://safetka.net .
conclusionsA web-based predictive model for AKI after TKA was developed using a machine-learning algorithm featuring six preoperative variables. The model is simple and has been validated to improve both short- and long-term prognoses of TKA patients. Postoperative AKI may lead to ESRD, which surgeons should strive to avoid. LEVEL OF EVIDENCE: Diagnostic level II.
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