Electronic Alert Systems for Patients With Acute Kidney Injury

作者：Jiajin Chen, Tao Han Lee, Ming‐Jen Chan, Tsung‐Yu Tsai, Pei‐Chun Fan, Cheng‐Chia Lee, Vin‐Cent Wu, Yu‐Kang Tu, Chih‐Hsiang Chang · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.30401 · 被引用次数：39 · 研究领域：Acute Kidney Injury Research、Chronic Kidney Disease and Diabetes、Dialysis and Renal Disease Management

Importance: The acute kidney injury (AKI) electronic alert (e-alert) system was hypothesized to improve the outcomes of AKI. However, its association with different patient outcomes and clinical practice patterns remains systematically unexplored. Objective: To assess the association of AKI e-alerts with patient outcomes (mortality, AKI progression, dialysis, and kidney recovery) and clinical practice patterns. Data Sources: A search of Embase and PubMed on March 18, 2024, and a search of the Cochrane Library on March 20, 2024, to identify all relevant studies. There were no limitations on language or article types. Study Selection: Studies evaluating the specified outcomes in adult patients with AKI comparing AKI e-alerts with standard care or no e-alerts were included. Studies were excluded if they were duplicate cohorts, had insufficient outcome data, or had no control group. Data Extraction and Synthesis: Two investigators independently extracted data and assessed bias. The systematic review and meta-analysis followed the PRISMA guidelines. Random-effects model meta-analysis, with predefined subgroup analysis and trial sequential analyses, were conducted. Main Outcomes and Measures: Primary outcomes included mortality, AKI progression, dialysis, and kidney recovery. Secondary outcomes were nephrologist consultations, post-AKI exposure to nonsteroidal anti-inflammatory drugs (NSAID), post-AKI angiotensin-converting enzyme inhibitor and/or angiotensin receptor blocker (ACEI...