Value of electronic alerts for acute kidney injury in high-risk wards: a pilot randomized controlled trial

• Published in: International urology and nephrology Vol. 50; no. 8; pp. 1483 - 1488
• Main Authors: Wu, Yanhua, Chen, Yuanhan, Li, Shaowen, Dong, Wei, Liang, Huaban, Deng, Miaoyi, Chen, Yingnan, Chen, Shixin, Liang, Xinling
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2018; Springer Nature B.V
• Subjects: Acute Kidney Injury - diagnosis; Acute Kidney Injury - mortality; Acute Kidney Injury - therapy; Aged; Algorithms; China - epidemiology; Clinical Alarms - statistics & numerical data; Creatinine; Diagnosis; Dialysis; Disease Progression; Early Diagnosis; Female; Follow-Up Studies; Hospital Mortality - trends; Humans; Intensive Care Units; Kidneys; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Nephrology - Original Paper; Pilot Projects; Prevalence; Prospective Studies; Rehabilitation; Renal Dialysis; Renal function; Risk Factors; Survival Rate - trends; Time Factors; Urology; China; Diagnosis; Information system; Surveillance; e-alert; Acute kidney injury
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-018-1836-7

Purpose To investigate the application value of “electronic alerts” (“e-alerts”) for acute kidney injury (AKI) among high-risk wards of hospitals. Methods A prospective, randomized, controlled study was conducted. We developed an e-alert system for AKI and ran the system in intensive care units and divisions focusing on cardiovascular disease. The e-alert system diagnosed AKI automatically based on serum creatinine levels. Patients were assigned randomly to an e-alert group (467 patients) or non-e-alert group (408 patients). Only the e-alert group could receive pop-up messages. Results The sensitivity, specificity, Youden Index and accuracy of the AKI e-alert system were 99.8, 97.7, 97.5 and 98.1%, respectively. The prevalence of the diagnosis for AKI and expanded-AKI (AKI or multiple-organ failure) in the e-alert group was higher than that in the non-e-alert group (AKI 7.9 and 2.7%, P  = 0.001; expanded-AKI 16.3 and 6.1%, P  < 0.001). The prevalence of nephrology consultation in the e-alert group was higher than that in the non-e-alert group (9.0 and 3.7%, P  = 0.001). There was no significant difference in the prevalence dialysis, rehabilitation of renal function or death in the two groups. Conclusion The e-alert system described here was a reliable tool to make an accurate diagnosis of AKI.