In the Journals

Multidisciplinary approach using EMR may decrease hypotension, AKI rates after total joint arthroplasty

Hypotension and acute kidney injury rates significantly decreased after the implementation of an electronic medical record protocol which included preoperative risk stratification, multidisciplinary medical optimization and a postoperative management plan for patients who underwent total joint replacement, according to recently published results.

For 36 months, researchers followed 1,233 patients who underwent TJA. A protocol to limit complication rates was implemented by a multi-disciplinary team at a suburban hospital. Investigators compared hypotension, AKI, length of stay, readmission rates before (group 1) and after implementation of the protocol (group 2) and after integration of the protocol into EMRs (group 3).

Results showed after use of the protocol in EMRs (group 3), hypotension rates were significantly lower compared to rates before initiation of the protocol (group 1). The rates after protocol implementation without EMRs (group 2) trended toward a significant decrease from rates pre-protocol. There was no difference in hypotension rates between protocol implementation (group 2) and integration into EMRs (group 3).

Investigators noted the AKI rates after protocol implementation into EMRs (group 3) were significantly lower than rates before implementation (group 1). No difference was seen in AKI rates before (group 1) and after the implementation of the protocol when EMRs were not used (group 3). Length of stay, readmission rates and mortality rates were not significantly different among groups. – by Monica Jaramillo

 

Disclosures: The authors report no relevant financial disclosures.

Hypotension and acute kidney injury rates significantly decreased after the implementation of an electronic medical record protocol which included preoperative risk stratification, multidisciplinary medical optimization and a postoperative management plan for patients who underwent total joint replacement, according to recently published results.

For 36 months, researchers followed 1,233 patients who underwent TJA. A protocol to limit complication rates was implemented by a multi-disciplinary team at a suburban hospital. Investigators compared hypotension, AKI, length of stay, readmission rates before (group 1) and after implementation of the protocol (group 2) and after integration of the protocol into EMRs (group 3).

Results showed after use of the protocol in EMRs (group 3), hypotension rates were significantly lower compared to rates before initiation of the protocol (group 1). The rates after protocol implementation without EMRs (group 2) trended toward a significant decrease from rates pre-protocol. There was no difference in hypotension rates between protocol implementation (group 2) and integration into EMRs (group 3).

Investigators noted the AKI rates after protocol implementation into EMRs (group 3) were significantly lower than rates before implementation (group 1). No difference was seen in AKI rates before (group 1) and after the implementation of the protocol when EMRs were not used (group 3). Length of stay, readmission rates and mortality rates were not significantly different among groups. – by Monica Jaramillo

 

Disclosures: The authors report no relevant financial disclosures.