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Improving acute kidney injury management in lower limb arthroplasty: an educational approach

  • Original Article • GENERAL ORTHPAEDICS - HIP
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Acute kidney injury (AKI) is a common but preventable cause of morbidity in elective arthroplasty patients. This study aimed to review the incidence and management of AKI in patients undergoing elective lower limb arthroplasty and compare results to those after the introduction of educational measures to improve prevention, recognition and management of AKI.

Methods

A retrospective case note review of all patients undergoing elective hip or knee arthroplasty between August and October 2013 was performed. Results were compared to patients treated from February to April 2014, after the introduction of a renal protection protocol, checklist poster and educational sessions. Results were statistically compared using Fisher’s exact test.

Results

Two hundred and eleven patients were included in the study: 104 in the initial cohort and 107 in the second cohort. Twenty patients (19.2 %) developed AKI in the initial cohort and 12 patients (11.2 %) in the second (p = 0.13). Recognition, documentation and management of AKI were significantly better following educational sessions and dissemination of posters throughout clinical areas, with 75 % of patients in the second cohort having their AKI documented and treated versus 30 % in the initial cohort.

Discussion/conclusions

This quality improvement project has demonstrated the significant impact that simple educational measures can have on improving AKI prevention, recognition and management in patients undergoing elective arthroplasty surgery. The introduction of a logical treatment checklist has been well received by both medical and nursing staff and ensures prompt and efficient management of AKI in a non-specialist area.

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Author information

Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Altnagelvin Area Hospital, Glenshane Road, Londonderry, BT47 6SB, Northern Ireland, UK

    Alistair I. W. Mayne & Neville W. Thompson

Authors
  1. Alistair I. W. Mayne
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  2. Neville W. Thompson
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Corresponding author

Correspondence to Alistair I. W. Mayne.

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Conflict of interest

Alistair Mayne and Neville Thompson declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

All patients included had valid informed consent completed for their arthroplasty surgery. Specific informed consent for inclusion in this study was not sought as this was a quality improvement project.

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Mayne, A.I.W., Thompson, N.W. Improving acute kidney injury management in lower limb arthroplasty: an educational approach. Eur J Orthop Surg Traumatol 26, 195–198 (2016). https://doi.org/10.1007/s00590-015-1734-y

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  • DOI: https://doi.org/10.1007/s00590-015-1734-y

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