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Randomized Controlled Trial
. 2018 Aug;50(8):1483-1488.
doi: 10.1007/s11255-018-1836-7. Epub 2018 Mar 19.

Value of electronic alerts for acute kidney injury in high-risk wards: a pilot randomized controlled trial

Yanhua Wu  1 , Yuanhan Chen  2 , Shaowen Li  3 , Wei Dong  1 , Huaban Liang  1 , Miaoyi Deng  3 , Yingnan Chen  3 , Shixin Chen  4 , Xinling Liang  5
Affiliations
Randomized Controlled Trial

Value of electronic alerts for acute kidney injury in high-risk wards: a pilot randomized controlled trial

Yanhua Wu et al. Int Urol Nephrol. 2018 Aug.

Abstract

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.

Keywords: Acute kidney injury; Diagnosis; Information system; Surveillance; e-alert.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Structure of the electronic-alert system for AKI
Fig. 2
Fig. 2
Trial profile
See this image and copyright information in PMC

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