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The role of an electronic alert system to detect acute kidney injury in hospitalized patients: DETECT-H Project.

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Title: The role of an electronic alert system to detect acute kidney injury in hospitalized patients: DETECT-H Project.
Alternate Title: Utilidad de un sistema de alerta electrónica para la detección de fracaso renal agudo en pacientes hospitalizados. Proyecto DETECT-H.
Authors: Labrador Gómez, Pedro Jesús1,2 pjlabrador@yahoo.es, González Sanchidrián, Silvia1,2, Labrador Gómez, Jorge2, Gómez-Martino Arroyo, Juan Ramón1, Jiménez Herrero, María Carmen2, Polanco Candelario,1, Santiago José Abraham, Marín Álvarez, Jesús Pedro1, Gallego Domínguez, Sandra1, Davin Carrero, Elena1, Sánchez Montalbán, José María1, Castellano CerviŞo, Inés1, Rosner, Mitchell H.3, Ronco, Claudio4,5
Source: Nefrologia. jul/ago2019, Vol. 39 Issue 4, p379-387. 9p.
Subjects: ACUTE kidney failure, ELECTRONIC systems, HOSPITAL patients, HOSPITAL mortality, GLOMERULAR filtration rate
Abstract (English): Background and aims: Acute kidney injury (AKI) is associated with higher mortality and length of stay (LOS) for hospitalized patients. To improve outcomes, an electronic detection system could be a useful tool for early diagnosis. Methods: A fully automated real-time system for detecting decreased glomerular filtration rate in adult patients was developed in our hospital, DETECT-H project. AKI was established according to KDIGO guidelines. Results: In six months, 1241 alerts from 11,022 admissions were issued. Overall incidence of AKI was 7.7%. Highest AKI stage reached was: stage 1 (49.8%), 2 (24.5%) and 3 (25.8%), in-hospital mortality was 10.9%, 22.7%, 33.9% respectively and 57.1% in AKI requiring dialysis; mortality in stable CKD was 4.3%. Median LOS was 8 days versus 5 days for all patients. AKI was associated with a mortality of 3.18 (95% CI 1.80-5.59) and a LOS 1.52 (1.11-2.08) times as high as that for admissions without AKI. Multivariate analysis indicated that a LOS higher than 8 days was associated with AKI. Previous CKD was noted in 31.9% and AKI in 45.3% at discharge. As compared to the use of the detect system, only one third of CKD patients and half of AKI episodes were identified. Conclusions: CKD and in-hospital AKI are under-recognized entities. Mortality and LOS are increased in-hospital patients with renal dysfunction. AKI severity was associated with higher mortality and LOS. An automated electronic detection system for identifying renal dysfunction would be a useful tool to improve renal outcomes. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción y objetivos: El fracaso renal agudo (FRA) aumenta la mortalidad y la estancia hospitalarias (EH). El empleo de sistemas de detección electrónica podría ser una herramienta beneficiosa para mejorar estos resultados. Métodos: Se desarrolló un sistema de detección automático a tiempo real de pacientes ingresados con función renal alterada, denominado proyecto DETECT-H. El FRA se estableció de acuerdo con las guías KDIGO. Resultados: En 6 meses, 1.241 alertas fueron recogidas de 11.022 ingresos. La incidencia global del FRA fue del 7,7%. La distribución en función del estadio máximo del FRA alcanzado fue: estadio 1: 49,8%, estadio 2: 24,5% y estadio 3: 25,8%; con una mortalidad hospitalaria del 10,9, 22,7 y 33,9%, respectivamente. En el caso del FRA con necesidad de diálisis fue del 57,1%. La mortalidad en pacientes con enfermedad renal crónica (ERC) estable fue del 4,3%. La mediana de EH en pacientes detectados fue 8 vs. 5 días para todos los pacientes hospitalizados. El FRA se asoció con una mortalidad 3,18 (1,8-5,59) y una EH 1,52 (1,11-2,08) veces superior que aquellos ingresos sin FRA. El análisis multivariante indicó que el FRA se asociaba con la EH > 8 días. En los informes de alta, la presencia de ERC previa solo fue registrada en el 31,9% de los pacientes con ERC y el FRA hospitalario en el 45,3%. Conclusiones: La ERC y el FRA intrahospitalario son entidades infradiagnosticadas. La mortalidad y la EH están aumentadas en pacientes con disfunción renal. La gravedad del FRA se asoció con mayor mortalidad y EH. Un sistema de detección automático para identificarlos podría ser útil para mejorar estos resultados. [ABSTRACT FROM AUTHOR]
Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The role of an electronic alert system to detect acute kidney injury in hospitalized patients: DETECT-H Project.
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  Data: Utilidad de un sistema de alerta electrónica para la detección de fracaso renal agudo en pacientes hospitalizados. Proyecto DETECT-H.
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  Data: <searchLink fieldCode="AR" term="%22Labrador+Gómez%2C+Pedro+Jesús%22">Labrador Gómez, Pedro Jesús</searchLink><relatesTo>1,2</relatesTo><i> pjlabrador@yahoo.es</i><br /><searchLink fieldCode="AR" term="%22González+Sanchidrián%2C+Silvia%22">González Sanchidrián, Silvia</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Labrador+Gómez%2C+Jorge%22">Labrador Gómez, Jorge</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Gómez-Martino+Arroyo%2C+Juan+Ramón%22">Gómez-Martino Arroyo, Juan Ramón</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Jiménez+Herrero%2C+María+Carmen%22">Jiménez Herrero, María Carmen</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Polanco+Candelario%2C1%2C+Santiago+José+Abraham%22">Polanco Candelario,1, Santiago José Abraham</searchLink><br /><searchLink fieldCode="AR" term="%22Marín+Álvarez%2C+Jesús+Pedro%22">Marín Álvarez, Jesús Pedro</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Gallego+Domínguez%2C+Sandra%22">Gallego Domínguez, Sandra</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Davin+Carrero%2C+Elena%22">Davin Carrero, Elena</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Sánchez+Montalbán%2C+José+María%22">Sánchez Montalbán, José María</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Castellano+CerviŞo%2C+Inés%22">Castellano CerviŞo, Inés</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Rosner%2C+Mitchell+H%2E%22">Rosner, Mitchell H.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Ronco%2C+Claudio%22">Ronco, Claudio</searchLink><relatesTo>4,5</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Nefrologia%22">Nefrologia</searchLink>. jul/ago2019, Vol. 39 Issue 4, p379-387. 9p.
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  Data: <searchLink fieldCode="DE" term="%22ACUTE+kidney+failure%22">ACUTE kidney failure</searchLink><br /><searchLink fieldCode="DE" term="%22ELECTRONIC+systems%22">ELECTRONIC systems</searchLink><br /><searchLink fieldCode="DE" term="%22HOSPITAL+patients%22">HOSPITAL patients</searchLink><br /><searchLink fieldCode="DE" term="%22HOSPITAL+mortality%22">HOSPITAL mortality</searchLink><br /><searchLink fieldCode="DE" term="%22GLOMERULAR+filtration+rate%22">GLOMERULAR filtration rate</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Background and aims: Acute kidney injury (AKI) is associated with higher mortality and length of stay (LOS) for hospitalized patients. To improve outcomes, an electronic detection system could be a useful tool for early diagnosis. Methods: A fully automated real-time system for detecting decreased glomerular filtration rate in adult patients was developed in our hospital, DETECT-H project. AKI was established according to KDIGO guidelines. Results: In six months, 1241 alerts from 11,022 admissions were issued. Overall incidence of AKI was 7.7%. Highest AKI stage reached was: stage 1 (49.8%), 2 (24.5%) and 3 (25.8%), in-hospital mortality was 10.9%, 22.7%, 33.9% respectively and 57.1% in AKI requiring dialysis; mortality in stable CKD was 4.3%. Median LOS was 8 days versus 5 days for all patients. AKI was associated with a mortality of 3.18 (95% CI 1.80-5.59) and a LOS 1.52 (1.11-2.08) times as high as that for admissions without AKI. Multivariate analysis indicated that a LOS higher than 8 days was associated with AKI. Previous CKD was noted in 31.9% and AKI in 45.3% at discharge. As compared to the use of the detect system, only one third of CKD patients and half of AKI episodes were identified. Conclusions: CKD and in-hospital AKI are under-recognized entities. Mortality and LOS are increased in-hospital patients with renal dysfunction. AKI severity was associated with higher mortality and LOS. An automated electronic detection system for identifying renal dysfunction would be a useful tool to improve renal outcomes. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción y objetivos: El fracaso renal agudo (FRA) aumenta la mortalidad y la estancia hospitalarias (EH). El empleo de sistemas de detección electrónica podría ser una herramienta beneficiosa para mejorar estos resultados. Métodos: Se desarrolló un sistema de detección automático a tiempo real de pacientes ingresados con función renal alterada, denominado proyecto DETECT-H. El FRA se estableció de acuerdo con las guías KDIGO. Resultados: En 6 meses, 1.241 alertas fueron recogidas de 11.022 ingresos. La incidencia global del FRA fue del 7,7%. La distribución en función del estadio máximo del FRA alcanzado fue: estadio 1: 49,8%, estadio 2: 24,5% y estadio 3: 25,8%; con una mortalidad hospitalaria del 10,9, 22,7 y 33,9%, respectivamente. En el caso del FRA con necesidad de diálisis fue del 57,1%. La mortalidad en pacientes con enfermedad renal crónica (ERC) estable fue del 4,3%. La mediana de EH en pacientes detectados fue 8 vs. 5 días para todos los pacientes hospitalizados. El FRA se asoció con una mortalidad 3,18 (1,8-5,59) y una EH 1,52 (1,11-2,08) veces superior que aquellos ingresos sin FRA. El análisis multivariante indicó que el FRA se asociaba con la EH > 8 días. En los informes de alta, la presencia de ERC previa solo fue registrada en el 31,9% de los pacientes con ERC y el FRA hospitalario en el 45,3%. Conclusiones: La ERC y el FRA intrahospitalario son entidades infradiagnosticadas. La mortalidad y la EH están aumentadas en pacientes con disfunción renal. La gravedad del FRA se asoció con mayor mortalidad y EH. Un sistema de detección automático para identificarlos podría ser útil para mejorar estos resultados. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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