title: Use of an electronic alert to identify patients with acute kidney injury.
abstract: Early intervention in the management of acute kidney injury (AKI) has been shown to improve outcomes. To facilitate early review we have introduced real time reporting for AKI. An algorithm using the laboratory computer system was implemented to report AKI for inpatients. Over 6 months there were 1,906 AKI reports in 1,518 patients: 56.3% AKI1, 26.9% AKI2 and 16.8% AKI3. 51.0% were male. Median age was 78 (interquartile range [IQR] 17) years. 62.6% were from general medical wards, 16.9% from surgical wards, 6.9% from orthopaedic wards and 5.3% from specialty wards. 8.3% were from peripheral hospitals. 31% of patients with AKI reports were clinically coded for AKI. 9% (n = 139) showed progression of AKI (mortality 42%). Patients with AKI had a significantly higher length of stay and mortality than those that did not. 4% of patients with AKI received acute renal replacement therapy (RRT). An e-alert system is feasible, allowing early identification of inpatients with AKI.
authors.affiliation: Royal Cornwall Hospital, Truro, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Wallace
authors.forename: Angela S
authors.initials: AS
authors.lastname: Mallard
authors.forename: Jon D
authors.initials: JD
authors.lastname: Stratton
authors.forename: Paul A
authors.initials: PA
authors.lastname: Johnston
authors.forename: Stephen
authors.initials: S
authors.lastname: Dickinson
authors.forename: Rob G
authors.initials: RG
authors.lastname: Parry
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification / Q000175:diagnosis* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D056902:Clinical Alarms; D002984:Clinical Laboratory Information Systems; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Acute kidney injury (AKI); e-alert; electronic alert; mortality; outcomes