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Impact of electronic AKI alert/care bundle on AKI inpatient outcomes: a retrospective single-center cohort study
作者: Chen-Xu, Michael; Kassam, Christopher; Cameron, Emma; Ryba, Szymon; Yiu, Vivian
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Background: Outcomes among acute kidney injury (AKI) patients are poor in United Kingdom (UK) hospitals, and electronic alerts and care bundles may improve them. We implemented such a system at West Suffolk Hospital (WSH) called the 'AKI order set'. We aimed to assess its impact on all-cause mortality, length of stay (LOS) and renal function among AKI patients, and its utilization. Methods: Retrospective, single-center cohort study of patients >= 18 years old with AKI at WSH, a 430-bed general hospital serving a rural UK population of approximately 280,000. 7243 unique AKI events representing 5728 patients with full data were identified automatically from our electronic health record (EHR) between 02 September 2018 and 1 July 2021 (median age 78 years, 51% male). All-cause mortality, LOS and improvement in AKI stage, demographic and comorbidity data, medications and AKI order set use were automatically collected from the EHR. Results: The AKI order set was used in 9.8% of AKI events and was associated with 28% lower odds of all-cause mortality (multivariable odds ratio [OR] 0.72, 95% confidence interval [CI] 0.57-0.91). Median LOS was longer when the AKI order set was utilized than when not (11.8 versus 8.8 days, p < .001), but was independently associated with improvement in the AKI stage (28.9% versus 8.7%, p < .001; univariable OR 4.25, 95% CI 3.53-5.10, multivariable OR 4.27, 95% CI 3.54-5.14). Conclusions: AKI order set use led to improvements in all-cause mortality and renal function, but longer LOS, among AKI patients at WSH.

关 键 词: Acute kidney injury; electronic alerting; care bundle; renal failure; quality improvement
论文来源: RENAL FAILURE.2024,46(1)
语种: 英文
所属领域: 人力资源外包
入库时间: 2024-03-11
浏览次数: 1