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Published on: May 15, 2020
Value of electronic alerts for acute kidney injury in high-risk wards: a pilot randomized controlled trial
Yanhua Wu1, Yuanhan Chen2, Shaowen Li3
1Division of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106, Zhong Shan Road 2, Guangzhou City, 510080, Guangdong Province, China.
Purpose:
To investigate the application value of "electronic alerts" ("e-alerts") for acute kidney injury (AKI) among high-risk wards of hospitals.
Methods:
A prospective, randomized, controlled study was conducted. We developed an e-alert system for AKI and ran the system in intensive care units and divisions focusing on cardiovascular disease. The e-alert system diagnosed AKI automatically based on serum creatinine levels. Patients were assigned randomly to an e-alert group (467 patients) or non-e-alert group (408 patients). Only the e-alert group could receive pop-up messages.
Results:
The sensitivity, specificity, Youden Index and accuracy of the AKI e-alert system were 99.8, 97.7, 97.5 and 98.1%, respectively. The prevalence of the diagnosis for AKI and expanded-AKI (AKI or multiple-organ failure) in the e-alert group was higher than that in the non-e-alert group (AKI 7.9 and 2.7%, P = 0.001; expanded-AKI 16.3 and 6.1%, P < 0.001). The prevalence of nephrology consultation in the e-alert group was higher than that in the non-e-alert group (9.0 and 3.7%, P = 0.001). There was no significant difference in the prevalence dialysis, rehabilitation of renal function or death in the two groups.
Conclusion:
The e-alert system described here was a reliable tool to make an accurate diagnosis of AKI.
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