| Objective: Contrast-induced acute kidney injury(CI-AKI)is a major adverse effect of contrast agents in the kidney,which can significantly delay the length of hospitalization,increase healthcare costs,and also progress to chronic kidney disease.Hydration is the most commonly used preventive measure yet.The current status of CI-AKI management in China is unknown and is hard to conduct further targeted management.Thus,we aimed to(1)Develop four versions of questionnaires for physicians,nurses,pharmacists,and patients with contrast agent on the current status of CI-AKI management.(2)To investigate the current situation of prevention and management of CI-AKI in some hospitals of Hunan province,and to analyze the prevention and management of CI-AKI and its influencing factors.(3)To investigate the hydration compliance of angiography patients and analyze its influencing factors,providing reference for improving the hydration compliance of patients.Methods:(1)Four questionnaires were developed for the management status of CI-AKI among doctors,nurses,pharmacists and patients based on two rounds of Delphin Method and preliminary survey.(2)The questionnaires were distributed in 14 hospitals in Hunan province from September 2021 to January 2022.SPSS 22.0 was used for data analysis.(3)The patients were divided into high compliance group and low compliance group according to their hydration compliance,and univariate and binary Logistic regression analysis were performed to identify the relevant influencing factors of hydration compliance.Results:(1)Four versions of questionnaires for doctors,nurses,pharmacists and patients were developed according to the scientific and standardized questionnaire design process.(2)A total of 1005 questionnaires were completed,including 443 from pharmacists,336 from doctors,330 from nurses,and 226 from patients.The results showed that the respondents had a high evaluation of the importance of CI-AKI management measures,with an overall score of 56.70±4.65 points(total score of 60 points).One-Way ANOVA showed that the score had significant differences in different profession,gender,educational background,title,and clinical and medical science departments(P<0.05).The respondents were poor in knowledge related to CI-AKI,with an overall pass rate of 43.01%.Binary Logistic regression analysis of CI-AKI knowledge level showed that master degree or above was independently associated with higher pass rate(OR: 2.121;95%CI:1.614-2.787).There are deficiencies in the management of CI-AKI in Hunan hospitals,which are mainly manifested as irrational use of contrast agents,non-standard dosage of contrast agents,poor health education of patients,lacking of standard hydration program,low attention of renal function and high-risk patients.(3)The hydration compliance of angiography patients was only 71.68%.Males were independently associated with lower compliance(OR: 0.456;95%CI: 0.229-0.908);The combination of CI-AKI risk factors(OR:3.177;95%CI: 1.505-6.706)and hydration requirements before and after angiography(OR: 2.927;95%CI:1.361-6.293)were independently associated with higher hydration compliance.Conclusions:(1)Hospitals in Hunan province lack a unified CI-AKI management model,the management of clinical intervention are diversified.Moreover,the clinical practice is different from the current guidelines or consensus,which needs to be improved.(2)The hydration compliance of patients needs to be further improved and health education of patients should be strengthened by medical staff. |
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