ArticleInternational journal of environmental research and public health2022
An Early Warning System for the Differential Diagnosis of In-Hospital Acute Kidney Injury for Better Patient Outcome: Study of a Quality Improvement Initiative.
Article in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Automated Electronic Alert for the Care and Outcomes of Adults With Acute Kidney Injury: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Acute Kidney Injury Provider and Survivor Education: Current and Emerging Tools.Advances in kidney disease and health · 2025Review
- An early HMGB1 rise 12 hours before creatinine predicts acute kidney injury and multiple organ failure in a smoke inhalation and burn swine model.Frontiers in immunology · 2024Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Acute kidney injury (AKI) is a syndrome with heterogeneous causes and mechanisms. An early warning system (EWS) for AKI was created to reduce the incidence and improve outcomes. However, the benefits of AKI-EWS remain debatable. Methods: We launched a project to design and create AKI-EWS for inpatients in our institute. Incidence of AKI and its outcome before and after the implementation of AKI-EWS were collected for analysis. Results: We enlisted a stakeholder map before creating AKI-EWS. We then started an action plan for this initiative. The diagnosis was automatic and based on the definition of Kidney Disease: Improving Global Outcomes (KDIGO). The differential diagnosis of causes of AKI was also automatic. Users are to adjust the threshold of detection. After the implementation of this AKI-EWS, the incidence of AKI fell. The proportion of AKI > 4% was reduced significantly (47.7% and 41.6%, p = 0.010) in patients with serum creatinine measured. The proportion of AKI > 0.9% also dropped significantly (51.67% and 35.94%, p = 0.024) in all inpatients. Trends of AKI outcomes also showed improvement. The loading of consultation of nephrologists decreased by 15.5%. Conclusions: Through well-designed AKI-EWS, the incidence of AKI dropped, showing improved outcomes. The factors affecting benefits from AKI-EWS included high-risk identification (individual threshold detection), timely and automatic diagnosis, real-time alerting on electronic health information systems, fast self-diagnosing of the cause of AKI, and coverage of all inpatients.
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