Addressing the gap in perioperative AKI risk identification: A two-phase project of a renal risk-stratification tool implementation

Abstract

Acute kidney injury (AKI) remains a common yet under-recognised perioperative complication associated with significant morbidity and mortality. Despite technological advances in monitoring and interventions, preoperative identification of at-risk patients remains suboptimal. This project aimed to assess the need and efficacy of a renal risk-stratification tool at a large Level 1 trauma centre in Eastern Georgia, combining qualitative findings and retrospective chart review analysis to guide perioperative AKI prevention. The project involved a two-phase approach: assess the need for a risk tool by surveying stakeholders, followed by piloting the Bell et al model retrospectively on 125 randomly selected patients at the facility. Findings revealed 42% of patients were at moderate to high risk for AKI, emphasising the utility of structured renal assessments to inform clinical decisions and improve outcomes.