Hospital Program Does Not Cut Mortality for Acute Kidney Injury
But drop in hospital length of stay, improvement in metrics seen
FRIDAY, Feb. 22, 2019 (HealthDay News) -- A multifaceted intervention for acute kidney injury (AKI), which includes AKI e-alerts, an AKI care bundle, and an education program, does not reduce 30-day mortality but reduced AKI episode duration and hospital length of stay, according to a study published online Feb. 21 in the Journal of the American Society of Nephrology.
Nicholas M. Selby, B.M., B.S., D.M., from the University of Nottingham in the United Kingdom, and colleagues examined a multifaceted intervention introduced to hospitals sequentially according to a randomly determined schedule across fixed three-month periods. A total of 24,059 AKI episodes were studied, with the primary outcome of 30-day mortality.
The researchers found that the overall 30-day mortality was 24.5 percent, with no difference observed between the control and intervention periods. There was a significant reduction in hospital length of stay in association with the intervention (decrease of 0.7, 1.1, and 1.3 days at the 0.5, 0.6, and 0.7 quantiles, respectively). There was also an increase in AKI incidence, mirrored by an increase in the proportion of patients with a coded AKI diagnosis, likely due to increased recognition. In 1,048 patients, assessment of process measures indicated improvements in several metrics, including AKI recognition, medication optimization, and fluid assessment.
"In conclusion, a strategy to reduce avoidable harm associated with AKI did not alter 30-day AKI mortality but was effective in reducing duration of AKI episodes and hospital length of stay, and resulted in better AKI recognition," the authors write.