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dc.contributor.authorKolhe, Nitin
dc.contributor.authorTaal, Maarten
dc.contributor.authorSelby, Nicholas
dc.contributor.authorFluck, Richard
dc.contributor.authorLeung, Janson
dc.contributor.authorReilly, Timothy
dc.contributor.authorSwinscoe, Kirsty
dc.date.accessioned2016-08-23T15:18:17Z
dc.date.available2016-08-23T15:18:17Z
dc.date.issued2016-05
dc.identifier.citationNephrol Dial Transplant. 2016 May 4. pii: gfw087. [Epub ahead of print]language
dc.identifier.urihttp://hdl.handle.net/20.500.12904/755
dc.descriptionAuthor(s) Pre and Post Print Onlylanguage
dc.description.abstractBACKGROUND: Consensus guidelines for acute kidney injury (AKI) have recommended prompt treatment including attention to fluid balance, drug dosing and avoidance of nephrotoxins. These simple measures can be incorporated in a care bundle to facilitate early implementation. The objective of this study was to assess the effect of compliance with the AKI care bundle (AKI-CB) on in-hospital case-fatality and AKI progression. METHODS: In this larger, propensity score-matched cohort of multifactorial AKI, we examined the impact of compliance with an AKI-CB in 3717 consecutive episodes of AKI in 3518 patients between 1 August 2013 and 31 January 2015. Propensity score matching was performed to match 939 AKI events where the AKI-CB was completed with 1823 AKI events where AKI-CB was not completed. RESULTS: The AKI-CB was completed in 25.6% of patients within 24 h. The unadjusted case-fatality was higher when the AKI-CB was not completed versus when the AKI-CB was completed (24.4 versus 20.4%, P = 0.017). In multivariable analysis, AKI-CB completion within 24 h was associated with lower odds for in-hospital death [odds ratio (OR): 0.76; 95% confidence interval (95% CI): 0.62-0.92]. Increasing age (OR: 1.04; 95% CI: 1.03-1.05), hospital-acquired AKI (OR: 1.28; 95% CI: 1.04-1.58), AKI stage 2 (OR: 1.91; 95% CI: 1.53-2.39) and increasing Charlson's comorbidity index (CCI) [OR: 3.31 (95% CI: 2.37-4.64) for CCI of more than 5 compared with zero] had higher odds for death, whereas AKI during elective admission was associated with lower odds for death (OR: 0.29; 95% CI: 0.16-0.52). Progression to higher AKI stages was lower when the AKI-CB was completed (4.2 versus 6.7%, P = 0.02). CONCLUSIONS: Compliance with an AKI-CB was associated with lower mortality and reduced progression of AKI to higher stages. The AKI-CB is simple and inexpensive, and could therefore be applied in all healthcare settings to improve outcomes.language
dc.language.isoenlanguage
dc.subjectAgelanguage
dc.subjectCare Bundlelanguage
dc.subjectMortalitylanguage
dc.subjectOutcomelanguage
dc.subjectAcute Kidney Injurylanguage
dc.titleA simple care bundle for use in acute kidney injury: a propensity score matched cohort study.language
dc.typeArticlelanguage
refterms.dateFOA2021-06-03T10:09:39Z


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