TY - JOUR
T1 - Drug-related causes attributed to acute kidney injury and their documentation in intensive care patients
AU - Murphy, Rachel M
AU - Dongelmans, Dave A
AU - Kom, Izak Yasrebi-de
AU - Calixto, Iacer
AU - Abu-Hanna, Ameen
AU - Jager, Kitty J
AU - de Keizer, Nicolette F
AU - Klopotowska, Joanna E
N1 - Funding Information: We thank Martijn C. Schut for his assistance in implementation of computer code and Rudy Scholte from Research Data Management for his assistance in data retrieval. MedDRA® trademark is registered by ICH. Funding Information: This study was funded partly by Innovation fund 2019 of Amsterdam UMC (project number: 23088) and by The Netherlands Organization for Health Research and Development (ZonMw project number: 848018004). The funders had no role in the design of the study, the collection, analysis, and interpretation of data or in writing the manuscript. Publisher Copyright: © 2023 The Authors
PY - 2023/6
Y1 - 2023/6
N2 - PURPOSE: To investigate drug-related causes attributed to acute kidney injury (DAKI) and their documentation in patients admitted to the Intensive Care Unit (ICU).METHODS: This study was conducted in an academic hospital in the Netherlands by reusing electronic health record (EHR) data of adult ICU admissions between November 2015 to January 2020. First, ICU admissions with acute kidney injury (AKI) stage 2 or 3 were identified. Subsequently, three modes of DAKI documentation in EHR were examined: diagnosis codes (structured data), allergy module (semi-structured data), and clinical notes (unstructured data).RESULTS: n total 8124 ICU admissions were included, with 542 (6.7%) ICU admissions experiencing AKI stage 2 or 3. The ICU physicians deemed 102 of these AKI cases (18.8%) to be drug-related. These DAKI cases were all documented in the clinical notes (100%), one in allergy module (1%) and none via diagnosis codes. The clinical notes required the highest time investment to analyze.CONCLUSIONS: Drug-related causes comprise a substantial part of AKI in the ICU patients. However, current unstructured DAKI documentation practice via clinical notes hampers our ability to gain better insights about DAKI occurrence. Therefore, both automating DAKI identification from the clinical notes and increasing structured DAKI documentation should be encouraged.
AB - PURPOSE: To investigate drug-related causes attributed to acute kidney injury (DAKI) and their documentation in patients admitted to the Intensive Care Unit (ICU).METHODS: This study was conducted in an academic hospital in the Netherlands by reusing electronic health record (EHR) data of adult ICU admissions between November 2015 to January 2020. First, ICU admissions with acute kidney injury (AKI) stage 2 or 3 were identified. Subsequently, three modes of DAKI documentation in EHR were examined: diagnosis codes (structured data), allergy module (semi-structured data), and clinical notes (unstructured data).RESULTS: n total 8124 ICU admissions were included, with 542 (6.7%) ICU admissions experiencing AKI stage 2 or 3. The ICU physicians deemed 102 of these AKI cases (18.8%) to be drug-related. These DAKI cases were all documented in the clinical notes (100%), one in allergy module (1%) and none via diagnosis codes. The clinical notes required the highest time investment to analyze.CONCLUSIONS: Drug-related causes comprise a substantial part of AKI in the ICU patients. However, current unstructured DAKI documentation practice via clinical notes hampers our ability to gain better insights about DAKI occurrence. Therefore, both automating DAKI identification from the clinical notes and increasing structured DAKI documentation should be encouraged.
KW - Acute kidney injury
KW - Adverse drug event
KW - Automated identification
KW - Electronic health records
KW - Nephrotoxicity
KW - Phenotype algorithm
UR - http://www.scopus.com/inward/record.url?scp=85151463564&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jcrc.2023.154292
DO - https://doi.org/10.1016/j.jcrc.2023.154292
M3 - Article
C2 - 36959015
SN - 0883-9441
VL - 75
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154292
ER -