The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: Propensity score matched analysis

Hyung Jung Oh, Mi Jung Lee, Chan Ho Kim, Dae Young Kim, Hye Sun Lee, Jung Tak Park, Sungwon Na, SeungHyeok Han, Shin-Wook Kang, Shin Ok Koh, TaeHyun Yoo

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction: Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control. Methods: A total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day. Results: The down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT. Conclusions: A well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.

Original languageEnglish
Article number454
JournalCritical Care
Volume18
Issue number4
DOIs
Publication statusPublished - 2014 Aug 13

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Propensity Score
Renal Replacement Therapy
Acute Kidney Injury
Recovery of Function
Mortality
Kidney
Blood Cell Count
Quality of Health Care
Ultrafiltration
Critical Illness
Comorbidity
Erythrocytes
Nurses
Regression Analysis
Physicians
Health
Therapeutics

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Oh, Hyung Jung ; Lee, Mi Jung ; Kim, Chan Ho ; Kim, Dae Young ; Lee, Hye Sun ; Park, Jung Tak ; Na, Sungwon ; Han, SeungHyeok ; Kang, Shin-Wook ; Koh, Shin Ok ; Yoo, TaeHyun. / The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy : Propensity score matched analysis. In: Critical Care. 2014 ; Vol. 18, No. 4.
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abstract = "Introduction: Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control. Methods: A total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day. Results: The down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT. Conclusions: A well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.",
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The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy : Propensity score matched analysis. / Oh, Hyung Jung; Lee, Mi Jung; Kim, Chan Ho; Kim, Dae Young; Lee, Hye Sun; Park, Jung Tak; Na, Sungwon; Han, SeungHyeok; Kang, Shin-Wook; Koh, Shin Ok; Yoo, TaeHyun.

In: Critical Care, Vol. 18, No. 4, 454, 13.08.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy

T2 - Propensity score matched analysis

AU - Oh, Hyung Jung

AU - Lee, Mi Jung

AU - Kim, Chan Ho

AU - Kim, Dae Young

AU - Lee, Hye Sun

AU - Park, Jung Tak

AU - Na, Sungwon

AU - Han, SeungHyeok

AU - Kang, Shin-Wook

AU - Koh, Shin Ok

AU - Yoo, TaeHyun

PY - 2014/8/13

Y1 - 2014/8/13

N2 - Introduction: Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control. Methods: A total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day. Results: The down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT. Conclusions: A well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.

AB - Introduction: Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control. Methods: A total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day. Results: The down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT. Conclusions: A well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.

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