AI Article Synopsis
- Acute kidney injury (AKI) is often underdiagnosed in clinical settings, making timely management crucial for patient safety, which a new e-alert system at the University Medical Center Utrecht aims to improve by comparing current creatinine levels with historical data.
- By analyzing data from nearly 85,000 emergency department visits, researchers found that linking primary care and tertiary care data allowed for an additional 7,886 evaluations of AKI, with significant benefits observed particularly for women and those aged 60 and older.
- The study showed that while overall diagnosis times remained similar, cases identified in both datasets were diagnosed 2.8 days sooner, highlighting that integrating different data sources can enhance diagnostic accuracy and speed for AK
Article Abstract
Objective: Acute kidney injury (AKI) is easily missed and underdiagnosed in routine clinical care. Timely AKI management is important to decrease morbidity and mortality risks. We recently implemented an AKI e-alert at the University Medical Center Utrecht, comparing plasma creatinine concentrations with historical creatinine baselines, thereby identifying patients with AKI. This alert is limited to data from tertiary care, and primary care data can increase diagnostic accuracy for AKI. We assessed the added value of linking primary care data to tertiary care data, in terms of timely diagnosis or excluding AKI.
Methods: With plasma creatinine tests for 84,984 emergency department (ED) visits, we applied the Kidney Disease Improving Global Outcome guidelines in both tertiary care-only data and linked data and compared AKI cases.
Results: Using linked data, the presence of AKI could be evaluated in an additional 7886 ED visits. Sex- and age-stratified analyses identified the largest added value for women (an increase of 4095 possible diagnoses) and patients ≥60 years (an increase of 5190 possible diagnoses). We observed 398 additional visits where AKI was diagnosed, as well as 185 cases where AKI could be excluded. We observed no overall decrease in time between baseline and AKI diagnosis (28.4 days vs. 28.0 days). For cases where AKI was diagnosed in both data sets, we observed a decrease of 2.8 days after linkage, indicating a timelier diagnosis of AKI.
Conclusions: Combining primary and tertiary care data improves AKI diagnostic accuracy in routine clinical care and enables timelier AKI diagnosis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331570 | PMC |
| http://dx.doi.org/10.1177/20552076241271767 | DOI Listing |
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