Abstract: FR-PO046
Outcomes with Implementing CRRT in a Community Hospital
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Meier, Maggie, St. Luke's Hospital, Chesterfield, Missouri, United States
- Kaur, Harinderjeet, St. Luke's Hospital, Chesterfield, Missouri, United States
- Shailly, Rajat, St. Luke's Hospital, Chesterfield, Missouri, United States
- Haque, Ramza, St. Luke's Hospital, Chesterfield, Missouri, United States
- Alva, Nishith, St. Luke's Hospital, Chesterfield, Missouri, United States
- Camacho, Ricardo J., St. Luke's Hospital, Chesterfield, Missouri, United States
- Talebian, Amir soheil, St. Luke's Hospital, Chesterfield, Missouri, United States
- Asghar, Muhammad Farhan, St. Luke's Hospital, Chesterfield, Missouri, United States
- Pohlman, Thomas R., St. Luke's Medical Specialists, St. Louis, Missouri, United States
Background
Acute kidney injury incidence in critically ill patients ranges from 20 to 50% and is associated with a high mortality rate. The CDC reports a 2.29% increase in acute kidney injuries treated with dialysis from 2000 to 2014. Renal replacement therapy is commonly required in patients with severe acute kidney injury. AKI was associated with higher hospitalization costs than myocardial infarction and gastrointestinal bleeding, and costs were comparable to those for stroke, pancreatitis, and pneumonia. In February 2016, continuous renal replacement therapy (CRRT) became available in our community hospital in Chesterfield, Missouri. We analyzed our initial usage of CRRT to evaluate outcomes and costs.
Methods
We conducted a retrospective study of adult patients initiated on CRRT at St. Luke’s Hospital in Chesterfield, MO between February 2016 and May 2018. The data was collected via Cerner Powerchart. Data collection included baseline characteristics, hospitalization costs and disposition.
Results
Among 52 qualified patients, the average age was 66.75. 92% were Caucasian with a male predominance (62%). The prevalence of Hypertension was 75%, Anemia 70%, CKD 47%, Multiorgan Failure 79%, Mechanical Ventilation 73% and ECMO 12%. Our mean duration of CRRT days was 3.84 in 2016, 2.53 in 2017, and 2.2 in 2018. The average direct total cost of hospitalization was $82,858. Our mortality rate was 51%. Patient dispositions: home 21%, LTAC 11%, Rehab 9%, SNF 8%, Hospice 6% and Deceased 45%.
Conclusion
Our community hospital implementation of CRRT over a two year period had a mortality rate of 50.9%, which was better than mortality rates found in the literature of ~62%. CRRT in our community setting was associated with similar to better outcomes than reported in literature. We attribute this to a common CRRT EMR order set, limited settings in which CRRT is utilized (medical and surgical ICU) and initiation of CRRT limited to nephrology.