Does acute kidney injury alerting improve patient outcomes?

Jolene Atia, Felicity Evison, Suzy Gallier, Peter Hewins, Simon Ball, Joseph Gavin, Jamie Coleman, Mark Garrick, Tanya Pankhurst

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Abstract

BACKGROUND: Electronic alerts (e-alerts) for Acute Kidney Injury (AKI) have been implemented into a variety of different Electronic Health Records (EHR) systems worldwide in order to improve recognition and encourage early appropriate management of AKI. We were interested in the impact on patient safety, specialist referral and clinical management.

METHODS: All patients admitted to our institution with AKI were included in the study. We studied AKI progression, dialysis dependency, length of hospital stay, emergency readmission, ICU readmission, and death, before and after the introduction of electronic alerts. The impact on prescription of high risk drugs, fluid administration, and referral to renal services was also analysed.

RESULTS: After the introduction of the e-alert, progression to higher AKI stage, emergency readmission to hospital and death during admission were significantly reduced. More prescriptions were stopped for drugs that adversely affect renal function in AKI and there was a significant increase in the ICU admissions and in the number of patients having dialysis, especially in earlier stages. Longer term mortality, renal referrals, and fluid alteration did not change significantly after the AKI e-alert introduction.

CONCLUSIONS: AKI e-alerts can improve clinical outcomes in hospitalised patients.

Original languageEnglish
Article number14
Number of pages10
JournalBMC Nephrology
Volume24
Issue number1
DOIs
Publication statusPublished - 17 Jan 2023

Bibliographical note

© 2023. Crown.

Keywords

  • Humans
  • Renal Dialysis
  • Hospitalization
  • Length of Stay
  • Acute Kidney Injury/epidemiology
  • Hospitals

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