Holmes, Jennifer, Donovan, Kieron, Geen, John, Williams, John and Phillips, Aled O.  ORCID: https://orcid.org/0000-0001-9744-7113
2021.
Acute kidney injury demographics and outcomes: changes following introduction of electronic acute kidney injury alerts—an analysis of a national dataset.
Nephrology Dialysis Transplantation
36
(8)
, pp. 1433-1439.
10.1093/ndt/gfaa071
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Abstract
Background Electronic alerts for acute kidney injury (AKI) have been widely advocated. Our aim was to describe the changes in AKI demographics and outcomes following implementation of a national electronic AKI alert programme. Methods A prospective national cohort study was undertaken to collect data on all cases of AKI in adult patients (≥18 years of age) between 1 April 2015 and 31 March 2019. Results Over the period of data collection, there were 193 838 AKI episodes in a total of 132 599 patients. The lowest incidence of AKI was seen in the first year after implementation of electronic alerts. A 30-day mortality was highest in Year 1 and significantly lower in all subsequent years. A direct comparison of mortality in Years 1 and 4 demonstrated a significantly increased relative risk (RR) of death in Year 1: RR = 1.08 [95% confidence interval (CI) 1.054–1.114 P < 0.001]. This translates into a number needed to treat in Year 4 for one additional patient to survive of 69.5 (95% CI 51.7–106.2) when directly comparing the outcomes across the 2 years. The increase in the number of cases and improved outcomes was more pronounced in community-acquired AKI, and was associated with a significant increase in patient hospitalization. Conclusions This study represents the first large-scale dataset to clearly demonstrate that a national AKI alerting system which highlights AKI is associated with a change in both AKI demographics and patient outcomes.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine |
| Publisher: | Oxford University Press (OUP): Policy B - Oxford Open Option B |
| ISSN: | 0931-0509 |
| Date of First Compliant Deposit: | 17 June 2020 |
| Date of Acceptance: | 14 March 2020 |
| Last Modified: | 27 Nov 2024 23:45 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/132548 |
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