Reporting of estimated glomerular filtration rate: Effect on physician recognition of chronic kidney disease and prescribing practices for elderly hospitalized patients
Reporting of estimated glomerular filtration rate: Effect on physician recognition of chronic kidney disease and prescribing practices for elderly hospitalized patients
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DOI：
10.1002/jhm.172
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发表时间：
2007-03-01
影响因子：
2.6
通讯作者：
Schafers, Stephen J.
中科院分区：
文献类型：
--
作者：
Quartarolo, Jennifer M.;Thoelke, Mark;Schafers, Stephen J.
背景：医生对老年患者慢性肾脏病（CKD）的认识很差。目的：探讨老年住院患者报告肾小球滤过率（GFR）估计值对医生认知CKD和医生处方行为的影响。设计：一项回顾性与前瞻性结合的病历回顾项目。纳入的患者年龄为65岁或以上，肌酐值在正常实验室范围内（< 1.6 mg/dL）。干预：向医生报告GFR的计算估计值。干预措施对肾脏给药的抗生素和非甾体抗炎药（NSAIDS）和环氧合酶-2抑制剂（考克斯-2）在出院时处方的影响进行了评估。结果：干预前后，共260和198例患者分别被纳入。慢性肾脏疾病的识别率在两组中均较低，但在报告估计GFR后显示出显著增加（3.9%至12.6%，P
BACKGROUND: Physician recognition of chronic kidney disease (CKD) in elderly patients has been noted to be poor. These patients are at increased risk of medication dosing errors and acute renal failure.OBJECTIVE: To investigate the effect of reporting estimated glomerular filtration rate (GFR) of elderly hospitalized patients on physician recognition of CKD and physician prescribing behaviors.DESIGN: A retrospective combined with a prospective medical record review project.SETTING: A large academic medical center.PATIENTS: Patients included were 65 years of age or older and had creatinine values within the normal laboratory range (< 1.6 mg/dL).INTERVENTION: Reporting a calculated estimate of GFR to physicians.MEASUREMENTS: Rates of recognition of CKD were examined before and after the intervention. The effects of the intervention on prescription of renal-dosed antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDS) and cyclooxygenase-2 inhibitors (COX-2) at hospital discharge were assessed.RESULTS: A total of 260 and 198 patients were included before and after the intervention, respectively. Recognition of chronic kidney disease was low in both groups but demonstrated a significant increase following reporting of estimated GFR (3.9% to 12.6%, P