Impact of Electronic Alerts for Acute Kidney Injury on patient outcomes: interrupted time-series analysis of population cohort data

David Baird (Lead / Corresponding author), Nicosha De Souza, Rachael Logan, Heather Walker, Bruce Guthrie, Samira Bell (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

5 Downloads (Pure)

Abstract

Background: Automated acute kidney injury (AKI) electronic alerts (e-alerts) are rule-based warnings triggered by changes in creatinine, and are intended to facilitate earlier detection in AKI. We assessed the impact of the introduction in the Tayside region of Scotland in April 2015 of automated AKI e-alerts with an accompanying education programme.

Methods: Interrupted time-series analysis using segmented regression was performed involving all adults with AKI aged ≥18 years who had a serum creatinine measured between 1st April 2013 and 31st March 2017. Analysis evaluated associations of AKI e-alert introduction on rate and severity (stage 2-3) of AKI as well as mortality and occupied hospital bed days per patient per month in the population with AKI.

Results: There were 32,320 episodes of AKI during the observation period. Implementation of e-alerts had no effect on the rate of any AKI (incidence rate ratio [IRR] 0.996, 95% CI 0.991 to 1.001, p=0.086) or on the rate of severe AKI (IRR 0.995, 95% CI 0.990 to 1.000, p=0.061). Subgroup group analysis found no impact on the rate or severity of AKI in hospital or in the community. 30-day mortality following AKI did not improve (IRR 0.998, 95% CI 0.987 to 1.009, p=0.688). There was a slight reduction in occupied bed days (β-coefficient -0.059, 95% CI -0.094 to -0.025, p=0.002).

Conclusions: Introduction of automated AKI e-alerts was not associated with a change in the rate, severity or mortality associated with AKI but there was a small reduction in occupied hospital bed days.
Original languageEnglish
Pages (from-to)639-646
Number of pages8
JournalClinical Kidney Journal
Volume14
Issue number2
Early online date21 Oct 2020
DOIs
Publication statusPublished - Feb 2021

Keywords

  • AKI
  • electronic alert
  • epidemiology
  • mortality
  • patient outcomes

Fingerprint Dive into the research topics of 'Impact of Electronic Alerts for Acute Kidney Injury on patient outcomes: interrupted time-series analysis of population cohort data'. Together they form a unique fingerprint.

Cite this