AKI that necessitates KRT is associated with a high rate of death and use. The impact of an AKI Standardized Clinical Assessment and Management Plan (SCAMP) on patient outcomes such as death, hospital length of stay, and intensive care unit length of stay were investigated by the researchers for a study. In the critical care units of a big academic tertiary medical hospital, they conducted a 12-month controlled trial. In 4- to 6-week blocks, they switched between using the AKI-SCAMP and a “mock” control form. The major goal was to reduce the probability of inpatient death. Secondary outcomes including 30- and 60-day mortality, hospital length of stay, and intensive care unit length of stay were also predetermined. The impact of the AKI-SCAMP on mortality and duration of stay was estimated using generalized estimating equations.
The AKI-SCAMP group had 122 patients, while the control group had 102 patients. There was no statistically significant change in inpatient mortality related to the use of AKI-SCAMP (41% versus 47% control). AKI-SCAMP usage was related with substantially lower intensive care unit length of stay (mean, 8; 95% CI, 8- 9 days against mean, 12; 95% CI, 10 to 13 days; P<0.001) and hospital length of stay (mean, 25; 95% CI, 22 to 29 days versus mean, 30; 95% CI, 27 to 34 days; P=0.02). Patients in the AKI-SCAMP group were less likely than those in the control group to obtain KRT in the setting of physician-perceived treatment futility (2% versus 7%; P=0.003).
The use of the AKI-SCAMP tool for AKI KRT was not linked to inpatient mortality, but it was linked to shorter stays in the critical care unit, shorter stays in the hospital, and KRT utilization in situations of physician-perceived treatment futility.