Effect of clinical decision support systems on clinical outcome for acute kidney injury: a systematic review and meta-analysis

BMC Nephrology

Li Yang¹  Xizi Zheng¹  Damin Xu¹  Jinwei Wang¹  Jicheng Lv¹  Youlu Zhao¹  Shuangling Li² 

[1] Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People’s Republic of China;Surgical Intensive Care Unit, Peking University First Hospital, Beijing, China;

关键词: Acute kidney injury;    Care bundle;    Electronic alert;    Clinical decision support system;   

DOI  :  10.1186/s12882-021-02459-y

来源: Springer

【 摘 要 】

BackgroundClinical decision support systems including both electronic alerts and care bundles have been developed for hospitalized patients with acute kidney injury.MethodsElectronic databases were searched for randomized, before-after and cohort studies that implemented a clinical decision support system for hospitalized patients with acute kidney injury between 1990 and 2019. The studies must describe their impact on care processes, patient-related outcomes, or hospital length of stay. The clinical decision support system included both electronic alerts and care bundles.ResultsWe identified seven studies involving 32,846 participants. Clinical decision support system implementation significantly reduced mortality (OR 0.86; 95 % CI, 0.75–0.99; p = 0.040, I2 = 65.3 %; n = 5 studies; N = 30,791 participants) and increased the proportion of acute kidney injury recognition (OR 3.12; 95 % CI, 2.37–4.10; p < 0.001, I2 = 77.1 %; n = 2 studies; N = 25,121 participants), and investigations (OR 3.07; 95 % CI, 2.91–3.24; p < 0.001, I2 = 0.0 %; n = 2 studies; N = 25,121 participants).ConclusionsNonrandomized controlled trials of clinical decision support systems for acute kidney injury have yielded evidence of improved patient-centered outcomes and care processes. This review is limited by the low number of randomized trials and the relatively short follow-up period.

【 授权许可】

CC BY