Association of implementation of an EHR-based sepsis alert system with sepsis-associated acute kidney injury

Given the limited evidence, this study aimed to determine the impact of an electronic health record (EHR)-based sepsis alert on the incidence of sepsis-associated acute kidney injury (SA-AKI), adherence to the 3-h sepsis bundle, and other clinical outcomes.

This single-center, pre/post-implementation study analyzed adult patients who were admitted from the Emergency Department to the intensive care unit with sepsis at a tertiary hospital in the United States from January 2021 to December 2023. A total of 7137 patients were included in our analysis. We used interrupted time series models, adjusted for seasonality, to assess changes following the implementation of a sepsis screening and alert system at Emergency Department on July 1, 2022. The primary outcome was the incidence of SA-AKI.

After implementation, there was no significant immediate change in SA-AKI incidence (0.26%; 95% CI, -4.02 to 4.55), but a significant decreasing monthly trend was observed (-0.47% per month; 95% CI, -0.87 to -0.07). Adherence to the 3-h sepsis bundle showed a significant immediate increase (3.78%; 95% CI, 1.38 to 6.18). However, no significant changes were observed in in-hospital mortality or non-recovery from SA-AKI.

The sepsis alert tool was associated with a progressive reduction in SA-AKI incidence and improved bundle adherence but was not associated with changes in mortality or renal recovery.