Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Poznan, Poland.
Ren Fail. 2024 Dec;46(2):2400552. doi: 10.1080/0886022X.2024.2400552. Epub 2024 Sep 9.
To determine whether clinical decision support systems (CDSS) for acute kidney injury (AKI) would enhance patient outcomes in terms of mortality, dialysis, and acute kidney damage progression.
The systematic review and meta-analysis included the relevant randomized controlled trials (RCTs) retrieved from PubMed, EMBASE, Web of Science, Cochrane, and SCOPUS databases until 21st January 2024. The meta-analysis was done using (RevMan 5.4.1). PROSPERO ID: CRD42024517399.
Our meta-analysis included ten RCTs with 18,355 patients. There was no significant difference between CDSS and usual care in all-cause mortality (RR: 1.00 with 95% CI [0.93, 1.07], = 0.91) and renal replacement therapy (RR: 1.11 with 95% CI [0.99, 1.24], = 0.07). However, CDSS was significantly associated with a decreased incidence of hyperkalemia (RR: 0.27 with 95% CI [0.10, 0.73], = 0.01) and increased eGFR change (MD: 1.97 with 95% CI [0.47, 3.48], = 0.01).
CDSS were not associated with clinical benefit in patients with AKI, with no effect on all-cause mortality or the need for renal replacement therapy. However, CDSS reduced the incidence of hyperkalemia and improved eGFR change in AKI patients.
确定急性肾损伤 (AKI) 的临床决策支持系统 (CDSS) 是否会提高患者的死亡率、透析和急性肾损伤进展的结果。
系统综述和荟萃分析包括从 PubMed、EMBASE、Web of Science、Cochrane 和 SCOPUS 数据库中检索到的相关随机对照试验 (RCT)，时间截至 2024 年 1 月 21 日。使用 (RevMan 5.4.1) 进行荟萃分析。PROSPERO ID：CRD42024517399。
我们的荟萃分析包括 10 项 RCT，涉及 18355 名患者。CDSS 与常规护理在全因死亡率方面没有显著差异（RR：1.00，95%CI [0.93, 1.07]， = 0.91）和肾脏替代治疗（RR：1.11，95%CI [0.99, 1.24]， = 0.07）。然而，CDSS 与高钾血症发生率降低显著相关（RR：0.27，95%CI [0.10, 0.73]， = 0.01）和 eGFR 变化增加（MD：1.97，95%CI [0.47, 3.48]， = 0.01）。
CDSS 对 AKI 患者的临床获益没有影响，对全因死亡率或肾脏替代治疗的需求没有影响。然而，CDSS 降低了 AKI 患者高钾血症的发生率并改善了 eGFR 变化。
