A National audit of the care of patients with acute kidney injury in England and Wales in 2019 and the association with patient outcomes
Graham-Brown, M P M Hull, Katherine Medcalf, James Adenwalla, Sherna
Graham-Brown, M P M
Hull, Katherine
Medcalf, James
Adenwalla, Sherna
Abstract
Background: Acute kidney injury (AKI) is a common complication of hospitalisations. This national audit assessed the care received by patients with AKI in hospital Trusts in England and Wales.
Methods: Twenty four hospital Trusts across England and Wales took part. Patients with AKI stage2/3 were identified using the UK Renal Registry AKI master patient index. Data was returned through a secure portal with linkage to hospital episode statistic mortality and hospitalisation data. Completion rates of AKI care standards and regional variations in care were established.
Results: 989 AKI episodes were included in the analyses. In-hospital 30-day mortality was 31-33.1% (AKI 2/3). Standard AKI interventions were completed in >80% of episodes. Significant inter-hospital variation remained in attainment of AKI care standards after adjustment for age and sex. Recording of urinalysis (41.9%) and timely imaging (37.2%) were low. Information on discharge summaries relating to medication changes/re-commencement and follow-up blood tests associated with reduced mortality. No quality indicators relating to clinical management associated with mortality. Better communication on discharge summaries associated with reduced mortality.
Conclusions: Outcomes for patients with AKI in hospital remain poor. Regional variation in care exists. Work is needed to assess whether improving and standardising care improves patient outcomes.
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Date
2024-03
Type
Article
Subject
AKI, Acute Kidney Injury
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Citation
Graham-Brown, M. P. M., Casula, A., Savino, M., Humphrey, T., Pyart, R., Amaran, M., Williams, J., Crowe, K., Medcalf, J. F., & NEPHwork consortium collaborators. All involved in data collection and or local project setup and supervision (2024). A National audit of the care of patients with acute kidney injury in England and Wales in 2019 and the association with patient outcomes. Clinical medicine (London, England), 24(2), 100028. https://doi.org/10.1016/j.clinme.2024.100028