Acute kidney injury risk-based screening in pediatric inpatients: A pragmatic randomized trial
| العنوان: | Acute kidney injury risk-based screening in pediatric inpatients: A pragmatic randomized trial |
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| المؤلفون: | Sara L. Van Driest, Li Wang, Michael F. McLemore, Brian C. Bridges, Geoffrey M. Fleming, Tracy L. McGregor, Deborah P. Jones, Jana Shirey-Rice, Cheryl L. Gatto, James C. Gay, Daniel W. Byrne, Asli Weitkamp, Dan M. Roden, Gordon Bernard |
| المصدر: | Pediatric research |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, Adolescent, Reminder Systems, MEDLINE, urologic and male genital diseases, Intensive Care Units, Pediatric, Risk Assessment, Severity of Illness Index, Article, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Predictive Value of Tests, Risk Factors, 030225 pediatrics, Intensive care, medicine, Humans, Child, Creatinine, Inpatients, business.industry, Incidence (epidemiology), Acute kidney injury, Age Factors, Infant, Acute Kidney Injury, Length of Stay, medicine.disease, Decision Support Systems, Clinical, Tennessee, female genital diseases and pregnancy complications, 3. Good health, Clinical trial, chemistry, Pediatrics, Perinatology and Child Health, Emergency medicine, Hospital Information Systems, Female, business, 030217 neurology & neurosurgery, Biomarkers, Kidney disease |
| الوصف: | Background Pediatric acute kidney injury (AKI) is common and associated with increased morbidity, mortality, and length of stay. We performed a pragmatic randomized trial testing the hypothesis that AKI risk alerts increase AKI screening. Methods All intensive care and ward admissions of children aged 28 days through 21 years without chronic kidney disease from 12/6/2016 to 11/1/2017 were included. The intervention alert displayed if calculated AKI risk was > 50% and no serum creatinine (SCr) was ordered within 24 h. The primary outcome was SCr testing within 48 h of AKI risk > 50%. Results Among intensive care admissions, 973/1909 (51%) were randomized to the intervention. Among those at risk, more SCr tests were ordered for the intervention group than for controls (418/606, 69% vs. 361/597, 60%, p = 0.002). AKI incidence and severity were the same in intervention and control groups. Among ward admissions, 5492/10997 (50%) were randomized to the intervention, and there were no differences between groups in SCr testing, AKI incidence, or severity of AKI. Conclusions Alerts based on real-time prediction of AKI risk increased screening rates in intensive care but not pediatric ward settings. Pragmatic clinical trials provide the opportunity to assess clinical decision support and potentially eliminate ineffective alerts. |
| اللغة: | English |
| تدمد: | 1530-0447 0031-3998 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1acd40e4b419fc662443868520a7252d http://europepmc.org/articles/PMC6962531 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....1acd40e4b419fc662443868520a7252d |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 15300447 00313998 |
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