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Kidney Week

Abstract: FR-PO113

Post Discharge Follow-Up Care in AKI Hospitalizations: A Health Systems Approach

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Gudsoorkar, Prakash Shashikant, University of Cincinnati, Cincinnati, Ohio, United States
  • Modi, Jwalant R., University of Cincinnati, Cincinnati, Ohio, United States
  • Meganathan, Karthikeyan, University of Cincinnati, Cincinnati, Ohio, United States
  • Thakar, Charuhas V., University of Cincinnati, Cincinnati, Ohio, United States
Background

Acute kidney injury (AKI) survivors face increased risk of readmissions and fragmented post-discharge care. We operationalized and implemented a quality improvement program (QIP) to track metrics of readmissions and follow-up care after in AKI patients.

Methods

By automated informatics approach, from all renal consults except transplant we extracted AKI patients, reviewed by each calendar quarter (10/2015 to 09/2019). Outcome metrics were: i) 30- or 90-day readmission; ii) renal follow up in clinics or dialysis among eligible survivors.

Results

Of the 3,988 AKI patients (6,602 hospitalizations) 58.5% were male. Discharge disposition included 24% expired/hospice and 42% home (Fig 1). 2,591 (65%) were eligible for follow up care. The median time to readmission was 18 days (IQR=8-43); average 30- and 90-day readmission rate was 28% and 41% respectively (Fig 2). Of the eligible patients, renal follow up occurred in 38% (range 30-45%); of which clinic follow up was 33% (range 24-39%) and dialysis follow up was 5% (range 2-7%). The follow up trends were similar across quarters.

Conclusion

A prospective QIP of follow up care in AKI evaluates missed opportunities. This program can then help in implementation of post-discharge clinics and improve outcomes in AKI survivors.

Fig 1. Quartery trends

Fig 2. Discharge dispositions