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AKI Alerts

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32 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28143633/electronic-alerts-for-acute-kidney-injury
#1
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
#2
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...
January 27, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28122032/approaches-to-predicting-outcomes-in-patients-with-acute-kidney-injury
#3
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
#4
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...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28030861/the-use-of-automated-electronic-alerts-in-studying-short-term-outcomes-associated-with-community-acquired-acute-kidney-injury
#5
Adil M Hazara, Musab Elgaali, Sarah Naudeer, Stephen Holding, Sunil Bhandari
BACKGROUND/AIMS: The use of electronic alerts (e-alerts) may increase the detection rate of acute kidney injury (AKI) since they are sensitive to small changes in serum creatinine. Our aim was to follow-up a cohort of patients presenting to hospital from the community with AKI (community-acquired AKI [c-AKI]), detected through the use of e-alerts, and describe their short-term outcomes regardless of whether they were subsequently admitted to hospital. METHODS: Blood samples for all hospital attenders from the community either to the Accidents and Emergency department or one of the acute care areas of the hospital during a 6-month period (November 1, 2013-April 30, 2014) were screened for presence of c-AKI using a locally developed e-alerts system based on Kidney Disease: Improving Global Outcomes criteria...
2017: Nephron
https://www.readbyqxmd.com/read/28030868/implementation-of-an-automated-primary-care-acute-kidney-injury-warning-system-a-quantitative-and-qualitative-review-of-2-years-of-experience
#6
REVIEW
Omid Sadeghi Alavijeh, Jas Bansal, Katie Hadfield, Christopher Laing, Anne Dawnay
BACKGROUND: Acute kidney injury (AKI) is often detected late, leading to worse clinical outcomes. In 2012, we pioneered an AKI-alerting system for primary care clinicians (PCCs). We retrospectively analysed the alerts and evaluated PCC satisfaction to assess the feasibility of the system. METHODS: The study used a 2-pronged approach. AKI alerts, generated by an algorithm designed by University College London Hospital biochemistry department between June 2012 and June 2014, were analysed to reveal the demographics and outcomes of each patient generating an alert...
2017: Nephron
https://www.readbyqxmd.com/read/27951559/automated-electronic-alert-systems-for-acute-kidney-injury-current-status-and-future-perspectives
#7
Eiichiro Uchino, Naoya Kondo, Takeshi Matsubara, Motoko Yanagita
BACKGROUND: Acute kidney injury (AKI) is a common and serious condition, but the process of care for patients with AKI is currently suboptimal. Automated AKI electronic (e)-alert systems are expected to improve the process of care and patient outcomes. SUMMARY: There have been several reports on the implementation of e-alert systems, which have the potential to improve patient outcomes, but evidence of their effectiveness has not been established. There are some challenges to the development of better e-alert systems...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#8
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...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#9
COMMENT
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...
2016: Blood Purification
https://www.readbyqxmd.com/read/27729353/development-of-guidance-on-the-timeliness-in-response-to-acute-kidney-injury-warning-stage-test-results-for-adults-in-primary-care-an-appropriateness-ratings-evaluation
#10
Tom Blakeman, Kathryn Griffith, Dan Lasserson, Berenice Lopez, Jung Y Tsang, Stephen Campbell, Charles Tomson
OBJECTIVES: Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN: An appropriateness ratings evaluation using the RAND/UCLA Appropriateness Method. SETTING: Clinical scenarios were developed to test the timeliness in (1) communication of AKI warning stage test results from clinical pathology services to primary care, and (2) primary care clinician response to an AKI warning stage test result...
October 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27633727/development-of-a-multicenter-ward-based-aki-prediction-model
#11
Jay L Koyner, Richa Adhikari, Dana P Edelson, Matthew M Churpek
BACKGROUND AND OBJECTIVES: Identification of patients at risk for AKI on the general wards before increases in serum creatinine would enable preemptive evaluation and intervention to minimize risk and AKI severity. We developed an AKI risk prediction algorithm using electronic health record data on ward patients (Electronic Signal to Prevent AKI). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All hospitalized ward patients from November of 2008 to January of 2013 who had serum creatinine measured in five hospitals were included...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27577501/electronic-medical-record-based-predictive-model-for-acute-kidney-injury-in-an-acute-care-hospital
#12
Olga Laszczyńska, Milton Severo, Ana Azevedo
Patients with acute kidney injury (AKI) are at risk for increased morbidity and mortality. Lack of specific treatment has meant that efforts have focused on early diagnosis and timely treatment. Advanced algorithms for clinical assistance including AKI prediction models have potential to provide accurate risk estimates. In this project, we aim to provide a clinical decision supporting system (CDSS) based on a self-learning predictive model for AKI in patients of an acute care hospital. Data of all in-patient episodes in adults admitted will be analysed using "data mining" techniques to build a prediction model...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/27478598/provider-acceptance-of-an-automated-electronic-alert-for-acute-kidney-injury
#13
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/26571483/categories-of-hospital-associated-acute-kidney-injury-time-course-of-changes-in-serum-creatinine-values
#14
David G Warnock, T Clark Powell, John P Donnelly, Henry E Wang
UNLABELLED: Hospital-associated acute kidney injury (HA-AKI) is associated with increased inpatient mortality. Our objective was to categorize HA-AKI based on the timing of minimum and peak inpatient serum creatinine (sCr) and describe the association with inpatient mortality. MATERIALS AND METHODS: This study is a retrospective analysis of an administrative data set for adults admitted to a single medical center for over 4 years. Changes and timing of the minimum and peak sCr were used to define HA-AKI categories...
2015: Nephron
https://www.readbyqxmd.com/read/27257275/the-acute-kidney-injury-e-alert-and-clinical-care-bundles-the-road-to-success-is-always-under-construction
#15
Björn Meijers, Bart De Moor, Bart Van Den Bosch
No abstract text is available yet for this article.
June 2, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27317356/methodological-challenges-when-carrying-out-research-on-ckd-and-aki-using-routine-electronic-health-records
#16
Helen I McDonald, Catriona Shaw, Sara L Thomas, Kathryn E Mansfield, Laurie A Tomlinson, Dorothea Nitsch
Research regarding chronic kidney disease (CKD) and acute kidney injury (AKI) using routinely collected data presents particular challenges. The availability, consistency, and quality of renal data in electronic health records has changed over time with developments in policy, practice incentives, clinical knowledge, and associated guideline changes. Epidemiologic research may be affected by patchy data resulting in an unrepresentative sample, selection bias, misclassification, and confounding by factors associated with testing for and recognition of reduced kidney function...
June 15, 2016: Kidney International
https://www.readbyqxmd.com/read/27217196/a-sustained-quality-improvement-program-reduces-nephrotoxic-medication-associated-acute-kidney-injury
#17
Stuart L Goldstein, Theresa Mottes, Kendria Simpson, Cynthia Barclay, Stephen Muething, David B Haslam, Eric S Kirkendall
Exposure to nephrotoxic medication is among the most common causes of acute kidney injury (AKI) in hospitalized patients. Here we conducted a prospective quality improvement project implementing a systematic Electronic Health Record screening and decision support process (trigger) in our quaternary pediatric inpatient hospital. Eligible patients were noncritically ill hospitalized children receiving an intravenous aminoglycoside for more than 3 days or more than 3 nephrotoxins simultaneously (exposure) from September 2011 through March 2015...
July 2016: Kidney International
https://www.readbyqxmd.com/read/26925246/impact-of-electronic-alerting-of-acute-kidney-injury-workgroup-statements-from-the-15-th-adqi-consensus-conference
#18
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
#19
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/26882100/electronic-data-systems-and-acute-kidney-injury
#20
REVIEW
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
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