ArticlePloS one2018
The ICE-AKI study: Impact analysis of a Clinical prediction rule and Electronic AKI alert in general medical patients.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03047382 ('Preventable Acute Kidney Injury), which is not on this map. Cited by 41 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
'Preventable Acute Kidney Injury (AKI) Should Never Occur.' The Use of a Novel Electronic Prediction Alerting Tool to Deliver an Individualised Care Package for Hospital In-patients at Risk of AKI
Who cites it
41 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Effect of acute kidney injury care bundles on patient prognosis: a systematic review and meta-analysis.BMC nephrology · 2025Pooled it
- The influence of electronic AKI alert on prognosis of adult hospitalized patients: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Electronic Alert Systems for Patients With Acute Kidney Injury: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Effect of care bundles for acute kidney injury: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Impact of AKI care bundles on kidney and patient outcomes in hospitalized patients: a systematic review and meta-analysis.BMC nephrology · 2021Pooled it
- Effect of clinical decision support systems on clinical outcome for acute kidney injury: a systematic review and meta-analysis.BMC nephrology · 2021Pooled it
- Early Nephrology Consultation and Acute Kidney Injury in Hospitalized Patients: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Development and Validation of Machine Learning Models to Identify Emergency Department Patients at Increased Risk of New or Progressive Acute Kidney Injury.Journal of the American College of Emergency Physicians open · 2026Article
- Observational
- Machine Learning Models for Point-of-Care Diagnostics of Acute Kidney Injury.Diagnostics (Basel, Switzerland) · 2025Article
- Systematic Review and Meta-Analysis of Machine Learning Models for Acute Kidney Injury Risk Classification.Journal of the American Society of Nephrology : JASN · 2025Article
- Intermediate and long-term AKI outcomes in a public health system.Journal of nephrology · 2025Article
- Multicenter Development and Validation of a Multimodal Deep Learning Model to Predict Moderate to Severe AKI.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- The computerized algorithm for renal assessment improves diagnostic accuracy of renal impairment in hospitalized patients.Scientific reports · 2025Article
- Effect of Tiered Implementation of Clinical Decision Support System for Acute Kidney Injury and Nephrotoxin Exposure in Cardiac Surgery Patients.Applied clinical informatics · 2025Article
- 10 tips on how to use dynamic risk assessment and alerts for AKI.Clinical kidney journal · 2024Review
- Internal and External Validation of Machine Learning Models for Predicting Acute Kidney Injury Following Non-Cardiac Surgery Using Open Datasets.Journal of personalized medicine · 2024Article
- Adherence to guidelines for management of acute kidney injury.The Journal of international medical research · 2024Article
- Biomarker Enrichment in Sepsis-Associated Acute Kidney Injury: Finding High-Risk Patients in the Intensive Care Unit.American journal of nephrology · 2024Review
- Information displays for automated surveillance algorithms of in-hospital patient deterioration: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury (AKI) is assoicated with high mortality and measures to improve risk stratification and early identification have been urgently called for. This study investigated whether an electronic clinical prediction rule (CPR) combined with an AKI e-alert could reduce hospital-acquired AKI (HA-AKI) and improve associated outcomes. METHODS AND
findingsA controlled before-and-after study included 30,295 acute medical admissions to two adult non-specialist hospital sites in the South of England (two ten-month time periods, 2014-16); all included patients stayed at least one night and had at least two serum creatinine tests. In the second period at the intervention site a CPR flagged those at risk of AKI and an alert was generated for those with AKI; both alerts incorporated care bundles. Patients were followed-up until death or hospital discharge. Primary outcome was change in incident HA-AKI. Secondary outcomes in those developing HA-AKI included: in-hospital mortality, AKI progression and escalation of care. On difference-in-differences analysis incidence of HA-AKI reduced (odds ratio [OR] 0.990, 95% CI 0.981-1.000, P = 0.049). In-hospital mortality in HA-AKI cases reduced on difference-in-differences analysis (OR 0.924, 95% CI 0.858-0.996, P = 0.038) and unadjusted analysis (27.46% pre vs 21.67% post, OR 0.731, 95% CI 0.560-0.954, P = 0.021). Mortality in those flagged by the CPR significantly reduced (14% pre vs 11% post intervention, P = 0.008). Outcomes for community-acquired AKI (CA-AKI) cases did not change. A number of process measures significantly improved at the intervention site. Limitations include lack of randomization, and generalizability will require future investigation.
conclusionsIn acute medical admissions a multi-modal intervention, including an electronically integrated CPR alongside an e-alert for those developing HA-AKI improved in-hospital outcomes. CA-AKI outcomes were not affected. The study provides a template for investigations utilising electronically generated prediction modelling. Further studies should assess generalisability and cost effectiveness.
trial registrationClinicaltrials.org NCT03047382.
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