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AKI Alerts

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48 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29273153/electronic-alerts-for-acute-kidney-injury
#1
EDITORIAL
Paul M Palevsky
No abstract text is available yet for this article.
January 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29248142/impact-of-e-alert-systems-on-the-care-of-patients-with-acute-kidney-injury
#2
REVIEW
Crystal M Breighner, Kianoush B Kashani
With the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effects. In recent years, electronic alerts (e-alerts) have been implemented at various institutions to decrease the morbidity associated with acute kidney injury (AKI)...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29188454/a-narrative-review-of-the-impact-of-interventions-in-acute-kidney-injury
#3
REVIEW
Lynne Sykes, Rob Nipah, Philip Kalra, Darren Green
Acute kidney injury (AKI) is independently associated with significant morbidity and mortality, and is thus an important challenge facing physicians in modern healthcare. This narrative review assesses the impact of strategies employed to tackle AKI following the 2009 NCEPOD report on acute kidney injury (Sterwart et al. Acute kidney injury: adding insult to injury, pp 1-22, 2009). There is scarce and heterogeneous research into hard end points such as mortality and AKI progression for AKI interventions. This review found that e-alerts have varying effects on mortality and AKI progression, but decrease the incidence of contrast-induced AKI...
November 29, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29145061/utility-of-electronic-aki-alerts-in-intensive-care-a-national-multicentre-cohort-study
#4
Jennifer Holmes, Gethin Roberts, John Geen, Alan Dodd, Nicholas M Selby, Andrew Lewington, Gareth Scholey, John D Williams, Aled O Phillips
BACKGROUND: Electronic AKI alerts highlight changes in serum creatinine compared to the patient's own baseline. Our aim was to identify all AKI alerts and describe the relationship between electronic AKI alerts and outcome for AKI treated in the Intensive Care Unit (ICU) in a national multicentre cohort. METHODS: A prospective cohort study was undertaken between November 2013 and April 2016, collecting data on electronic AKI alerts issued. RESULTS: 10% of 47,090 incident AKI alerts were associated with ICU admission...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#5
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29025142/community-acquired-acute-kidney-injury-findings-from-a-large-population-cohort
#6
J Holmes, J Geen, B Phillips, J D Williams, A O Phillips
Background: The extent of patient contact with medical services prior to development of community acquired-acute kidney injury (CA-AKI)is unknown. Aim: We examined the relationship between incident CA-AKI alerts, previous contact with hospital or primary care and clinical outcomes. Design: A prospective national cohort study of all electronic AKIalerts representing adult CA-AKI. Methods: Data were collected for all cases of adult (≥18 years of age) CA-AKI in Wales between 1 November 2013 and 31 January 2017...
July 21, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28963291/systematic-review-of-prognostic-prediction-models-for-acute-kidney-injury-aki-in-general-hospital-populations
#7
Luke Eliot Hodgson, Alexander Sarnowski, Paul J Roderick, Borislav D Dimitrov, Richard M Venn, Lui G Forni
OBJECTIVE: Critically appraise prediction models for hospital-acquired acute kidney injury (HA-AKI) in general populations. DESIGN: Systematic review. DATA SOURCES: Medline, Embase and Web of Science until November 2016. ELIGIBILITY: Studies describing development of a multivariable model for predicting HA-AKI in non-specialised adult hospital populations. Published guidance followed for data extraction reporting and appraisal...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28861688/predicting-major-adverse-kidney-events-among-critically-ill%C3%A2-adults-using-the-electronic-health-record
#8
Andrew C McKown, Li Wang, Jonathan P Wanderer, Jesse Ehrenfeld, Todd W Rice, Gordon R Bernard, Matthew W Semler
Prediction of major adverse kidney events in critically ill patients may help target therapy, allow risk adjustment, and facilitate the conduct of clinical trials. In a cohort comprised of all critically ill adults admitted to five intensive care units at a single tertiary care center over one year, we developed a logistic regression model for the outcome of Major Adverse Kidney Events within 30 days (MAKE30), the composite of persistent renal dysfunction, new renal replacement therapy (RRT), and in-hospital mortality...
August 31, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28778364/information-technology-and-acute-kidney-injury-alerts-alarms-bells-and-whistles
#9
REVIEW
F Perry Wilson
The goal of this review is to describe the rationale for alerting systems for acute kidney injury, the challenges associated with alert implementation, and the efficacy (or lack thereof) of acute kidney injury alerts to date.
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28759604/a-web-based-tool-to-predict-acute-kidney-injury-in-patients-with-st-elevation-myocardial-infarction-development-internal-validation-and-comparison
#10
COMPARATIVE STUDY
Benjamin R Zambetti, Fridtjof Thomas, Inyong Hwang, Allen C Brown, Mason Chumpia, Robert T Ellis, Darshan Naik, Rami N Khouzam, Uzoma N Ibebuogu, Guy L Reed
BACKGROUND: In ST-elevation myocardial infarction (STEMI), acute kidney injury (AKI) may increase subsequent morbidity and mortality. Still, it remains difficult to predict AKI risk in these patients. We sought to 1) determine the frequency and clinical outcomes of AKI and, 2) develop, validate and compare a web-based tool for predicting AKI. METHODS & FINDINGS: In a racially diverse series of 1144 consecutive STEMI patients, Stage 1 or greater AKI occurred in 12...
2017: PloS One
https://www.readbyqxmd.com/read/28754457/impact-of-electronic-acute-kidney-injury-aki-alerts-with-automated-nephrologist-consultation-on-detection-and-severity%C3%A2-of-aki-a-quality-improvement-study
#11
Sehoon Park, Seon Ha Baek, Soyeon Ahn, Kee-Hyuk Lee, Hee Hwang, Jiwon Ryu, Shin Young Ahn, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
BACKGROUND: Several electronic alert systems for acute kidney injury (AKI) have been introduced. However, their clinical benefits require further investigation. STUDY DESIGN: Before-and-after quality improvement study. SETTING & PARTICIPANTS: A tertiary teaching hospital in Korea, which adopted an AKI alert system on June 1, 2014. Before and after launch of the alert system, 1,884 and 1,309 patients with AKI were included in the usual-care and alert groups, respectively...
July 25, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28751970/service-evaluation-of-the-implementation-of-a-digitally-enabled-care-pathway-for-the-recognition-and-management-of-acute-kidney-injury
#12
Alistair Connell, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, Omid Sadeghi-Alavijeh, Charles Merrick, Dominic King, Alan Karthikesalingam, Cian Hughes, Joseph Ledsam, Trevor Back, Geraint Rees, Rosalind Raine, Christopher Laing
Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians...
2017: F1000Research
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#13
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28486440/electronic-health-record-based-predictive-models-for-acute-kidney-injury-screening-in-pediatric-inpatients
#14
Li Wang, Tracy L McGregor, Deborah P Jones, Brian C Bridges, Geoffrey M Fleming, Jana Shirey-Rice, Michael F McLemore, Lixin Chen, Asli Weitkamp, Daniel W Byrne, Sara L Van Driest
BackgroundAcute kidney injury (AKI) is common in pediatric inpatients and is associated with increased morbidity, mortality, and length of stay. Its early identification can reduce severity.MethodsTo create and validate an electronic health record (EHR)-based AKI screening tool, we generated temporally distinct development and validation cohorts using retrospective data from our tertiary care children's hospital, including children aged 28 days through 21 years with sufficient serum creatinine measurements to determine AKI status...
September 2017: Pediatric Research
https://www.readbyqxmd.com/read/28483379/the-incidence-of-pediatric-acute-kidney-injury-is-increased-when-identified-by-a-change-in-a%C3%A2-creatinine-based-electronic-alert
#15
Jennifer Holmes, Gethin Roberts, Kate May, Kay Tyerman, John Geen, John D Williams, Aled O Phillips
A prospective national cohort study was undertaken to collect data on all cases of pediatric (under 18 yrs of age) acute kidney injury (AKI) identified by a biochemistry-based electronic alert using the Welsh National electronic AKI reporting system. Herein we describe the utility and limitation of using this modification of the KDIGO creatinine-based system data set to characterize pediatric AKI. Of 1,343 incident episodes over a 30-month period, 34.5% occurred in neonates of which 83.8% were AKI stage 1. Neonatal 30-day mortality was 4...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28402560/acute-kidney-injury-electronic-alerts-in-primary-care-findings-from-a-large-population-cohort
#16
J Holmes, N Allen, G Roberts, J Geen, J D Williams, A O Phillips
Background: Electronic reporting of AKI has been used to aid early AKI recognition although its relevance to CA-AKI and primary care has not been described. Aims: We described the characteristics and clinical outcomes of patients with CA-AKI, and AKI identified in primary care (PC-AKI) through AKI e-Alerts. Design: A prospective national cohort study was undertaken to collect data on all e-alerts representing adult CA-AKI. Method: The study utilized the biochemistry based AKI electronic (e)-alert system that is established across the Welsh National Health Service...
September 1, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28143633/electronic-alerts-for-acute-kidney-injury
#17
Michael Haase, Andreas Kribben, Walter Zidek, Jürgen Floege, Christian Albert, Berend Isermann, Bernt-Peter Robra, Anja Haase-Fielitz
BACKGROUND: Acute kidney injury (AKI) often takes a complicated course if diagnosed late and undertreated. Electronic alerts that provide an early warning of AKI are intended to support treating physicians in making the diagnosis of AKI and treating it appropriately. The available evidence on the effects of such alert systems is inconsistent. METHODS: We employed the PRISMA recommendations for systematic literature reviews to identify relevant articles in the PubMed, Scopus, and Web of Science databases...
January 9, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28130688/akipredictor-an-online-prognostic-calculator-for-acute-kidney-injury-in-adult-critically-ill-patients-development-validation-and-comparison-to-serum-neutrophil-gelatinase-associated-lipocalin
#18
Marine Flechet, Fabian Güiza, Miet Schetz, Pieter Wouters, Ilse Vanhorebeek, Inge Derese, Jan Gunst, Isabel Spriet, Michaël Casaer, Greet Van den Berghe, Geert Meyfroidt
PURPOSE: Early diagnosis of acute kidney injury (AKI) remains a major challenge. We developed and validated AKI prediction models in adult ICU patients and made these models available via an online prognostic calculator. We compared predictive performance against serum neutrophil gelatinase-associated lipocalin (NGAL) levels at ICU admission. METHODS: Analysis of the large multicenter EPaNIC database. Model development (n = 2123) and validation (n = 2367) were based on clinical information available (1) before and (2) upon ICU admission, (3) after 1 day in ICU and (4) including additional monitoring data from the first 24 h...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28122032/approaches-to-predicting-outcomes-in-patients-with-acute-kidney-injury
#19
Danielle Saly, Alina Yang, Corey Triebwasser, Janice Oh, Qisi Sun, Jeffrey Testani, Chirag R Parikh, Joshua Bia, Aditya Biswas, Chess Stetson, Kris Chaisanguanthum, F Perry Wilson
Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time-updated prognostic models using stepwise regression compared to more advanced variable selection techniques. We randomly split data into training and validation cohorts...
2017: PloS One
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#20
REVIEW
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
Background: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
February 1, 2017: Nephrology, Dialysis, Transplantation
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