title: The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: propensity score matched analysis.
abstract: BACKGROUND
  Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control.
  
  
  METHODS
  A total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day.
  
  
  RESULTS
  The down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT.
  
  
  CONCLUSIONS
  A well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.
authors.forename: Hyung Jung
authors.initials: HJ
authors.lastname: Oh
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Lee
authors.forename: Chan Ho
authors.initials: CH
authors.lastname: Kim
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.forename: Seung Hyeok
authors.initials: SH
authors.lastname: Han
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Shin Ok
authors.initials: SO
authors.lastname: Koh
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D000078329:Workforce