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AKI Alert

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https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#1
Jennifer Holmes, Timothy Rainer, John Geen, Gethin Roberts, Kate May, Nick Wilson, John D Williams, Aled O Phillips
BACKGROUND AND OBJECTIVES: Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community- and hospital-acquired adult AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults...
October 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27784284/case-report-severe-bradycardia-a-reversible-cause-of-cardio-renal-cerebral-syndrome
#2
Mabel Aoun, Randa Tabbah
BACKGROUND: Cardio-Renal Syndromes were first classified in 2008 and divided into five subtypes. The type 1 Cardio-Renal Syndrome (CRS) is characterized by acute decompensation of heart failure leading to acute kidney injury (AKI). Bradyarrhythmia was not mentioned in the classification as a cause for low cardiac output (CO) in type 1 CRS. Besides, CRS was not previously associated with central nervous system (CNS) injury despite the fact that cardiac, renal and neurological diseases can coexist...
October 26, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#3
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
October 14, 2016: Blood Purification
https://www.readbyqxmd.com/read/27543592/acute-kidney-outreach-to-reduce-deterioration-and-death-akordd-trial-the-protocol-for-a-large-pilot-study
#4
Tarek Samy Abdelaziz, Antje Lindenmeyer, Jyoti Baharani, Hema Mistry, Alice Sitch, R Mark Temple, Gavin Perkins, Mark Thomas
INTRODUCTION: Acute kidney injury (AKI) contributes to morbidity and mortality, and its care is often suboptimal and/or delayed. The Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) study is a large pilot testing provision of early specialist advice, to improve outcomes for patients with AKI. METHODS AND ANALYSIS: This before and after study will test an Outreach service for adult patients with AKI, identified using the national algorithm. During the 2-month before phase, AKI outcomes (30-day mortality, need for dialysis or AKI stage deterioration) will be observed in the intervention and control hospitals and their respective community areas; no interventions will be delivered...
2016: BMJ Open
https://www.readbyqxmd.com/read/27478598/provider-acceptance-of-an-automated-electronic-alert-for-acute-kidney-injury
#5
Janice Oh, Joshua R Bia, Muhamad Ubaid-Ullah, Jeffrey M Testani, Francis Perry Wilson
BACKGROUND: Clinical decision support systems, including electronic alerts, ideally provide immediate and relevant patient-specific information to improve clinical decision-making. Despite the growing capabilities of such alerts in conjunction with an expanding electronic medical record, there is a paucity of information regarding their perceived usefulness. We surveyed healthcare providers' opinions concerning the practicality and efficacy of a specific text-based automated electronic alert for acute kidney injury (AKI) in a single hospital during a randomized trial of AKI alerts...
August 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27376867/design-and-rationale-of-tackling-acute-kidney-injury-a-multicentre-quality-improvement-study
#6
Nicholas M Selby, Anna Casula, Laura Lamming, Mohammed Mohammed, Fergus Caskey
Acute kidney injury (AKI) is common and associated with extremely poor outcomes. While strategies to tackle deficiencies in basic care delivery are advocated, robust testing of their effectiveness is also needed. The Tackling AKI study was designed to test whether a complex intervention (consisting of an e-alert, care bundle and education programme) can be successfully implemented across a range of UK hospitals, and whether this will deliver improved patient outcomes. This multicentre, pragmatic clinical trial will employ a cluster randomised stepped wedge design to study this in all adult patients who sustain AKI in the 5 participating hospitals over a 2-year period...
July 5, 2016: Nephron
https://www.readbyqxmd.com/read/27231884/development-and-application-of-an-alert-system-to-detect-cases-of-food-poisoning-in-japan
#7
Akie Maeyashiki, Manabu Akahane, Hiroaki Sugiura, Yasushi Ohkusa, Nobuhiko Okabe, Tomoaki Imamura
Recent public health concerns regarding commercial food products have increased the need to develop an automated method to detect food product-related health events. We developed and verified a method for the early detection of potentially harmful events caused by commercial food products. We collected data from daily internet-based questionnaires examining the presence or absence of symptoms and information about food purchased by the respondents. Using these data, we developed a method to detect possible health concerns regarding commercialized food products...
2016: PloS One
https://www.readbyqxmd.com/read/27190340/kdigo-based-acute-kidney-injury-criteria-operate-differently-in-hospitals-and-the-community-findings-from-a-large-population-cohort
#8
Simon Sawhney, Nick Fluck, Simon D Fraser, Angharad Marks, Gordon J Prescott, Paul J Roderick, Corri Black
BACKGROUND: Early recognition of acute kidney injury (AKI) is important. It frequently develops first in the community. KDIGO-based AKI e-alert criteria may help clinicians recognize AKI in hospitals, but their suitability for application in the community is unknown. METHODS: In a large renal cohort (n = 50 835) in one UK health authority, we applied the NHS England AKI 'e-alert' criteria to identify and follow three AKI groups: hospital-acquired AKI (HA-AKI), community-acquired AKI admitted to hospital within 7 days (CAA-AKI) and community-acquired AKI not admitted within 7 days (CANA-AKI)...
June 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27150187/impact-of-e-alert-for-detection-of-acute-kidney-injury-on-processes-of-care-and-outcomes-protocol-for-a-systematic-review-and-meta-analysis
#9
Philippe Lachance, Pierre-Marc Villeneuve, Francis P Wilson, Nicholas M Selby, Robin Featherstone, Oleksa Rewa, Sean M Bagshaw
INTRODUCTION: Acute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients...
May 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/26944599/early-impact-on-renal-parenchymal-vascularization-of-chimney-grafts-versus-fenestrated-grafts
#10
REVIEW
E Ducasse, C Caradu, A Elicagaray, X Bérard, D Midy, L Stecken
OBJECTIVE: The primary objective of this retrospective study was to analyze the early impact of chimney (CG) versus fenestrated grafts (FG) on renal parenchymal vascularization and function. METHODS: All consecutive patients with juxta-renal abdominal aortic aneurysm (JR-AAA) treated by endovascular repair from December 2013 to July 2014 at the vascular unit, Pellegrin University Hospital, Bordeaux, France, were included. Serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were reported at baseline and at J2 for acute kidney injury (AKI) incidence, and at J7 for AKI staging (KDIGO criteria); renal resistive indices (RRI) were reported for renal parenchymal repercussion at J-1, J0, and J1...
May 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26925246/impact-of-electronic-alerting-of-acute-kidney-injury-workgroup-statements-from-the-15-th-adqi-consensus-conference
#11
REVIEW
Eric A J Hoste, Kianoush Kashani, Noel Gibney, F Perry Wilson, Claudio Ronco, Stuart L Goldstein, John A Kellum, Sean M Bagshaw
PURPOSE OF THE REVIEW: Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/26925245/applications-for-detection-of-acute-kidney-injury-using-electronic-medical-records-and-clinical-information-systems-workgroup-statements-from-the-15-th-adqi-consensus-conference
#12
REVIEW
Matthew T James, Charles E Hobson, Michael Darmon, Sumit Mohan, Darren Hudson, Stuart L Goldstein, Claudio Ronco, John A Kellum, Sean M Bagshaw
Electronic medical records and clinical information systems are increasingly used in hospitals and can be leveraged to improve recognition and care for acute kidney injury. This Acute Dialysis Quality Initiative (ADQI) workgroup was convened to develop consensus around principles for the design of automated AKI detection systems to produce real-time AKI alerts using electronic systems. AKI alerts were recognized by the workgroup as an opportunity to prompt earlier clinical evaluation, further testing and ultimately intervention, rather than as a diagnostic label...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/26910240/the-incidence-and-significance-of-acute-kidney-injury-following-emergent-contrast-administration-in-patients-with-stemi-and-stroke
#13
Michael Robert Marchick, Brandon Russell Allen, Emily Cassin Weeks, Jonathan Jacob Shuster, Marie-Carmelle Elie
The authors have investigated the incidence of acute kidney injury (AKI) and short-term mortality following an activated STEMI and stroke alert at a tertiary referral and academic center. A single center, retrospective chart review of STEMI and stroke activation patients from January 2010 to March 2012. Data was collected and reviewed from an institutional database following IRB-approval. Inclusion criteria were STEMI patients taken for cardiac catheterization, excluding patients receiving hemodialysis due to end-stage renal disease (ESRD)...
September 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26882100/electronic-data-systems-and-acute-kidney-injury
#14
Wisit Cheungpasitporn, Kianoush Kashani
Acute kidney injury (AKI) is a serious condition that is associated with an increased risk of death, long hospital stays, and high healthcare costs. The best chance of ameliorating the severity of AKI and improving its outcomes is through early recognition and intervention. Electronic health records (EHRs) have now become an integrated part of medical practice in most clinical settings worldwide. Appropriate use of EHRs potentially improves patient care, while poorly designed EHRs could result in unintended consequences...
2016: Contributions to Nephrology
https://www.readbyqxmd.com/read/26798462/computerized-clinical-decision-support-for-the-early-recognition-and-management-of-acute-kidney-injury-a-qualitative-evaluation-of-end-user-experience
#15
Nigel S Kanagasundaram, Mark T Bevan, Andrew J Sims, Andrew Heed, David A Price, Neil S Sheerin
BACKGROUND: Although the efficacy of computerized clinical decision support (CCDS) for acute kidney injury (AKI) remains unclear, the wider literature includes examples of limited acceptability and equivocal benefit. Our single-centre study aimed to identify factors promoting or inhibiting use of in-patient AKI CCDS. METHODS: Targeting medical users, CCDS triggered with a serum creatinine rise of ≥25 μmol/L/day and linked to guidance and test ordering. User experience was evaluated through retrospective interviews, conducted and analysed according to Normalization Process Theory...
February 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/26539921/automated-integrated-real-time-clinical-decision-support-in-acute-kidney-injury
#16
REVIEW
Stuart L Goldstein
PURPOSE OF REVIEW: Health information technology advancements have resulted in recent increased sophistication of the electronic health record, whereby patient demographic, physiological, and laboratory data can be extracted real-time and integrated into clinical decision support (CDS). RECENT FINDINGS: The implementation of health information technology advancements into CDS in the renal realm has been focused mainly on assessment of kidney function to guide medication dosing in the setting of reduced function or to reactively detect acute kidney injury (AKI) heralded by an abrupt increase in serum creatinine...
December 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26539920/recent-developments-in-electronic-alerts-for-acute-kidney-injury
#17
REVIEW
Kerry L Horne, Nicholas M Selby
PURPOSE OF REVIEW: Efforts to improve outcomes from acute kidney injury (AKI) have focussed on timely diagnosis and effective delivery of basic patient care. Electronic alerts (e-alerts) for AKI have attracted interest as a tool to facilitate this. Initial feasibility has already been demonstrated; this review will discuss recent advances in alert methodology, implementation beyond single centres and reported effect on outcomes. RECENT FINDINGS: On-going descriptions of e-alerts highlight increasing variation in both detection algorithms and alert processes...
December 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26512125/improving-outcomes-in-patients-with-acute-kidney-injury-the-impact-of-hospital-based-automated-aki-alerts
#18
M Prendecki, E Blacker, O Sadeghi-Alavijeh, R Edwards, H Montgomery, S Gillis, M Harber
BACKGROUND: Acute kidney injury (AKI) is a significant cause of morbidity and mortality. Early identification may improve the outcome and in 2012 our hospital introduced an automated AKI alert system for early detection and management of AKI. OBJECTIVES: Using an automated AKI alert system we analysed whether early review and intervention by the Critical Care and Outreach (CCOT) team improved patient outcomes in AKI and whether serum bicarbonate was useful in predicting outcomes in patients with AKI...
January 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/26351847/standardizing-the-early-identification-of-acute-kidney-injury-the-nhs-england-national-patient-safety-alert
#19
REVIEW
Nicholas M Selby, Robert Hill, Richard J Fluck
Whilst varying standards of care for patients with acute kidney injury (AKI) continue to contribute to poor outcomes, a strong focus on strategies to drive quality improvement is paramount. To this end, a national Patient Safety Alert was issued in June 2014 to all healthcare providers in England entitled 'Standardising the Early Identification of Acute Kidney Injury'. The aim was to embed an automated AKI detection system in the biochemistry laboratories of all acute hospitals. In addition to the direct clinical benefits that may come from earlier and more systematic recognition of AKI, it has also helped position AKI as a patient safety issue and will feed a national AKI registry, the latter a potent tool for future measurement and improvement initiatives...
2015: Nephron
https://www.readbyqxmd.com/read/26161979/impact-of-compliance-with-a-care-bundle-on-acute-kidney-injury-outcomes-a-prospective-observational-study
#20
Nitin V Kolhe, David Staples, Timothy Reilly, Daniel Merrison, Christopher W Mcintyre, Richard J Fluck, Nicholas M Selby, Maarten W Taal
BACKGROUND: A recent report has highlighted suboptimal standards of care for acute kidney injury (AKI) patients in England. The objective of this study was to ascertain if improvement in basic standard of care by implementing a care bundle (CB) with interruptive alert improved outcomes in patients with AKI. METHODS: An AKI CB linked to electronic recognition of AKI, coupled with an interruptive alert, was introduced to improve basic care delivered to patients with AKI...
2015: PloS One
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