A standardized risk mitigation process for patients undergoing PCI reduced acute kidney injury events by 35.7% and bleeding events by 53.2% compared to the previous 12-month baseline.
Observational
Does a formalized pre-procedure evaluation and clinical optimization process reduce AKI and bleeding events in patients undergoing PCI?
Implementing a standardized risk stratification and mitigation process significantly reduces procedure-associated acute kidney injury and bleeding in patients undergoing percutaneous coronary intervention.
Effect estimate: 35.7% reduction (AKI), 53.2% reduction (bleeding)
Introduction: For patients undergoing percutaneous coronary intervention (PCI), procedure-associated acute kidney injury (AKI) and bleeding are significant events that negatively impact morbidity, mortality, and healthcare costs. Methods: This nonexperimental quality improvement project aimed to reduce the incidence of AKI and bleeding events by formalizing the pre-procedure evaluation and clinical optimization processes, as well as enhancing intra- and post-procedural surveillance for high-risk patients. The rates of AKI and bleeding events before and after the intervention were assessed using data from the National Cardiovascular Data Registry (NCDR) CathPCI Registry. Results: During the 12-month intervention period, AKI events were reduced by 35.7%, and bleeding events decreased by 53.2% compared to the previous 12-month baseline. Both measures were substantially lower than the organization-wide average. Conclusions: A standardized process with objective risk stratification and consistent implementation of mitigation interventions reduces AKI and bleeding events. The SCAI PCI Risk Calculator is a valuable tool in identifying patients at high risk for PCI-associated AKI and bleeding with minimal impact on workflow. A systematic process owned by the cardiac cath lab team, supported by an advanced practice registered nurse in collaboration with procedural physicians, can enhance a culture of safety and reduce harm.
Seale et al. (Sun,) conducted a observational in Patients undergoing percutaneous coronary intervention (PCI). Standardized pre-procedure evaluation, clinical optimization, and enhanced surveillance vs. Previous 12-month baseline was evaluated on Incidence of AKI and bleeding events (35.7% reduction (AKI), 53.2% reduction (bleeding)). A standardized risk mitigation process for patients undergoing PCI reduced acute kidney injury events by 35.7% and bleeding events by 53.2% compared to the previous 12-month baseline.
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