Kidney Week

Abstract: TH-PO001

Interventions in Patient Pathways Reduce the Incidence and Complications of AKI

Session Information

• AKI: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Brazell, Madeline, South Tyneside NHS Foundation Trust , Gateshead, United Kingdom

Madeline Brazell,

• Chernick, Jonathan Anthony, South Tyneside NHS Foundation Trust , Gateshead, United Kingdom

Jonathan Anthony Chernick,

• Robinson, Anna, NHS England , Newcastle, United Kingdom

Anna Robinson,

• Jones, Philip H., South Tyneside District Hospital, Co Durham, United Kingdom

Philip H. Jones,

• Gaunt, Philippa L., South Tyneside NHS Foundation Trust, England, Gateshead, United Kingdom

Philippa L. Gaunt,

• Srivastava, Shalabh, City Hospitals Sunderland and South Tyneside NHS FT, Sunderland, United Kingdom

Shalabh Srivastava,

Background

We investigated the management and outcomes of patients developing AKI-3 in the South Tyneside area of the North East of England (population:153,700, census 2011). We proactively introduced interventions to aide early recognition and management of AKI. These interventions included intensive education for clinical staff in the community and hospitals, the launch of a nephrology outreach service in the South Tyneside Hospital and an online AKI health pathway tool.The study aims to scrutinize any changes in outcomes since interventions were delivered.

Methods

Methods: Data was gathered by interrogating the regional pathology database for all patients who developed AKI 3 during the periods of 1^st October 16 – 31^st December 2016 and subsequently from 1^st October 2017 – 31^st December 2017. Paediatric patients, palliative care patients and those on renal replacement therapy were excluded.

Results

We demonstrate an overall reduction of 17% in the development of AKI3 during the study period (68 vs 82 cases) additionally; we demonstrate a 29% reduction in the development of AKI-3 in hospital. The discharge to baseline creatinine ratio improved from 1.5:1 to 1.3:1. The admission to baseline creatinine ratio improved from 3.8:1 to 4.4:1. The overall mortality rates remain at 30.88% and the overall hospital stay did not change (16.1 days vs 16.2 days).

Conclusion

In conclusion, we demonstrate a significant improvement in the incidence of AKI-3 .There is early recognition of AKI and significant improvement in the renal function on discharge. We recognise that there was no improvement in overall mortality and the total number of in-patient days did not improve. Our data suggests that simple interventions at multiple levels in a patient’s pathway can lead to significant improvement in outcomes.

Comparison of Admission: Baseline and Discharge: Baseline Creatinine Ratios