Evidence map›Paper›PMID 39948464›Full record

ArticleBMC nephrology2025

Identifying acute kidney injury in children: comparing electronic alerts with health record data.

Lucy Plumb, Manuela Savino, Anna Casula, Manish D Sinha, Carol D Inward, Stephen D Marks, James Medcalf, Dorothea Nitsch

Abstract readComparative Study
In one paragraph

Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lucy PlumbUK Renal Registry, UK Kidney Association, Building 20A1, Filton 20, Filton, Bristol, BS34 7RR, UK. lucy.plumb@nhs.net.ORCID 0000-0002-3873-8567
Manuela SavinoBristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Anna CasulaUK Renal Registry, UK Kidney Association, Building 20A1, Filton 20, Filton, Bristol, BS34 7RR, UK.
Manish D SinhaEvelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK.
Carol D InwardDepartment of Paediatric Nephrology, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK.
Stephen D MarksDepartment of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
James MedcalfUK Renal Registry, UK Kidney Association, Building 20A1, Filton 20, Filton, Bristol, BS34 7RR, UK.
Dorothea NitschUK Renal Registry, UK Kidney Association, Building 20A1, Filton 20, Filton, Bristol, BS34 7RR, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElectronic (e-)alerts for rising serum creatinine values are increasingly used as clinical indicators of acute kidney injury (AKI). The aim of this study was to investigate to what degree AKI episodes, as identified using e-alerts, correlated with coding for AKI in the hospital record for a national cohort of hospitalised children and examine whether coding corresponded with 30-day mortality after an AKI episode.

methodsA cross-section of AKI episodes based on alerts issued for children under 18 years in England during 2017 were linked to hospital records. Multivariable logistic regression was used to examine patient and clinical factors associated with AKI coding. Agreement between coding and 30-day mortality was examined at hospital level.

results6272 AKI episodes in 5582 hospitalised children were analysed. Overall, coding was poor (19.7%). Older age, living in the least deprived quintile (odds ratio (OR) 1.4, 95% Confidence Interval (CI) 1.1, 1.7) and higher peak AKI stage (stage 1 reference; stage 2 OR 2.0, 95% CI 1.7, 2.4; stage 3 OR 8.6, 95% CI 7.1, 10.6) were associated with higher likelihood of coding in the hospital record. AKI episodes during birth admissions were less likely to be coded (OR 0.4, 95% CI 0.3, 0.5). No correlation was seen between coding and 30-day mortality.

conclusionsThe proportion of AKI alert-identified episodes coded in the hospital record is low, suggesting under-recognition and underestimation of AKI incidence. Understanding the reasons for inequalities in coding, variation in coding between hospitals and how alerts can enhance clinical recognition is needed.

Indexed as

Acute Kidney InjuryElectronic Health RecordsAdolescentChildChild, PreschoolCreatinineCross-Sectional StudiesEnglandFemaleHospitalizationHumansInfantInfant, NewbornMaleCreatinineAcute Kidney InjuryChildElectronic health recordsEpidemiologyPediatrics

Identifiers

PMID39948464
PMCPMC11827200

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.