From ef579dc962291b0d4a1235bcf206c3c95c7a3f99 Mon Sep 17 00:00:00 2001 From: Chessing234 Date: Wed, 27 May 2026 07:51:21 +0530 Subject: [PATCH] Fix KDIGO AKI Stage 3 SCr criterion to use a +0.3 increase instead of hardcoded 3.7 The Stage 3 branch for patients reaching SCr >= 4.0 mg/dL is supposed to require an acute increase of >= 0.3 within 48h (or >= 1.5x baseline). The condition was written as creat_low_past_48hr <= 3.7, which only equals a 0.3 increase when creat is exactly 4.0. For any creatinine above 4.0 (e.g. creat = 5.0 with a 48h low of 3.8) the real increase can be well above 0.3 yet still be missed, so genuine Stage 3 AKI is not flagged. Replace the hardcoded 3.7 with creat >= creat_low_past_48hr + 0.3. Co-Authored-By: Claude Opus 4.7 --- mimic-iii/concepts/organfailure/kdigo_stages.sql | 2 +- mimic-iv/concepts/organfailure/kdigo_stages.sql | 2 +- 2 files changed, 2 insertions(+), 2 deletions(-) diff --git a/mimic-iii/concepts/organfailure/kdigo_stages.sql b/mimic-iii/concepts/organfailure/kdigo_stages.sql index eff4c9da9..314e4a285 100644 --- a/mimic-iii/concepts/organfailure/kdigo_stages.sql +++ b/mimic-iii/concepts/organfailure/kdigo_stages.sql @@ -17,7 +17,7 @@ with cr_stg AS -- For patients reaching Stage 3 by SCr >4.0 mg/dl -- require that the patient first achieve ... acute increase >= 0.3 within 48 hr -- *or* an increase of >= 1.5 times baseline - and (cr.creat_low_past_48hr <= 3.7 OR cr.creat >= (1.5*cr.creat_low_past_7day)) + and (cr.creat >= (cr.creat_low_past_48hr+0.3) OR cr.creat >= (1.5*cr.creat_low_past_7day)) then 3 -- TODO: initiation of RRT when cr.creat >= (cr.creat_low_past_7day*2.0) then 2 diff --git a/mimic-iv/concepts/organfailure/kdigo_stages.sql b/mimic-iv/concepts/organfailure/kdigo_stages.sql index daf49fce2..8748ca39b 100644 --- a/mimic-iv/concepts/organfailure/kdigo_stages.sql +++ b/mimic-iv/concepts/organfailure/kdigo_stages.sql @@ -20,7 +20,7 @@ WITH cr_stg AS ( -- an acute increase >= 0.3 within 48 hr -- *or* an increase of >= 1.5 times baseline AND ( - cr.creat_low_past_48hr <= 3.7 OR cr.creat >= ( + cr.creat >= (cr.creat_low_past_48hr + 0.3) OR cr.creat >= ( 1.5 * cr.creat_low_past_7day ) )