Clinical Decision Support for In-Hospital AKI

AKI carries a significant mortality and morbidity risk. Use of a clinical decision support system (CDSS) might improve outcomes. We conducted a multicenter, sequential period analysis of 528,108 patients without ESRD before admission, from October of 2012 to September of 2015, to determine whether u...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 2018-02, Vol.29 (2), p.654-660
Main Authors: Al-Jaghbeer, Mohammed, Dealmeida, Dilhari, Bilderback, Andrew, Ambrosino, Richard, Kellum, John A
Format: Article
Language:English
Subjects:
Clinical Research
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Summary:AKI carries a significant mortality and morbidity risk. Use of a clinical decision support system (CDSS) might improve outcomes. We conducted a multicenter, sequential period analysis of 528,108 patients without ESRD before admission, from October of 2012 to September of 2015, to determine whether use of a CDSS reduces hospital length of stay and in-hospital mortality for patients with AKI. We compared patients treated 12 months before (181,696) and 24 months after (346,412) implementation of the CDSS. Coprimary outcomes were hospital mortality and length of stay adjusted by demographics and comorbidities. AKI was diagnosed in 64,512 patients (12.2%). Crude mortality rate fell from 10.2% before to 9.4% after CDSS implementation (odds ratio, 0.91; 95% confidence interval [95% CI], 0.86 to 0.96; =0.001) for patients with AKI but did not change in patients without AKI (from 1.5% to 1.4%). Mean hospital duration decreased from 9.3 to 9.0 days (
ISSN:1046-6673
1533-3450
DOI:10.1681/asn.2017070765