Electronic “early warning systems” for acute kidney injury (AKI) in hospital patients don’t improve outcomes, according to a study published in BMJ. For the study, investigators examined data from more than 6,000 adult patients with AKI at six Yale-affiliated hospitals for whom half of their healthcare providers received an alert about AKI and half had the function turned off. The alerts led to slight changes in care—including additional urine tests, more creatinine measurement, and increased documentation of the patients’ AKI— but resulted in no differences in outcomes. Patients in the alert group were as likely to have worsening AKI-related conditions, require dialysis, or die as those in the non-alert group. At two non-teaching hospital, the death rate for patients who received an AKI alert was 15.6%, compared with 8.6% for those who didn’t receive an alert.

Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial
BMJ 2021;372:m4786