TY - JOUR
T1 - Patterns of Cystatin C Uptake and Use Across and Within Hospitals
AU - Teaford, Hilary R.
AU - Rule, Andrew D.
AU - Mara, Kristin C.
AU - Kashani, Kianoush B.
AU - Lieske, John C.
AU - Schreier, Diana J.
AU - Wieruszewski, Patrick M.
AU - Barreto, Erin F.
N1 - Funding Information:
Grant Support: This project was supported in part by Mayo Clinic Department of Pharmacy, the National Center for Advancing Translational Sciences (NCATS), Grant Number UL1 TR002377 , and the National Institutes of Health Award Number K23AI143882 (PI: E.F.B.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding sources had no role in study design; data collection, analysis, or interpretation; writing the report; or the decision to submit the report for publication. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2020 Mayo Foundation for Medical Education and Research
PY - 2020/8
Y1 - 2020/8
N2 - Objective: To characterize the use of cystatin C (cysC) across and within hospitals. Patients and Methods: This 2-part study first evaluated access to cysC testing across 129 hospitals in the state of Minnesota, using a telephone-based survey. Second, granular data from a single center (Mayo Clinic) with on-site, rapid-turnaround testing (<1 day) and automated estimated glomerular filtration rate (eGFR) reporting was used to describe temporal patterns. The characteristics of hospitals that offered cysC testing and of patients who underwent rapid cysC testing at Mayo Clinic between January 1, 2011, and March 31, 2018, were described. Poisson regression analyzed temporal trends in cysC testing. Results: Of the 114 hospitals (88%) that responded to the statewide survey, cysC was available in 91 (80%), but only 3 of 91 (3%) reported a turnaround time of <1 day. At Mayo Clinic, cysC use increased from 0.74 tests per 1000 patient-days in 2011 to 14 tests per 1000 patient-days in 2018 (P=.004). Of the 3774 patients with cysC tests, the mean first available eGFR was 46 mL/min per 1.73 m2 using cysC and 59 mL/min per 1.73 m2 using serum creatinine (P<.001). CysC testing was used across all intensities of care and was ordered by a variety of specialties. Nephrology was consulted in only 42% of cases. Conclusion: In the hospital, rapid-turnaround cysC testing is necessary for practical use but was not widely available in Minnesota. When available, a marked increase in cysC testing was observed over the study timeframe. Additional research is needed to determine optimal strategies for implementation of cysC within hospitals.
AB - Objective: To characterize the use of cystatin C (cysC) across and within hospitals. Patients and Methods: This 2-part study first evaluated access to cysC testing across 129 hospitals in the state of Minnesota, using a telephone-based survey. Second, granular data from a single center (Mayo Clinic) with on-site, rapid-turnaround testing (<1 day) and automated estimated glomerular filtration rate (eGFR) reporting was used to describe temporal patterns. The characteristics of hospitals that offered cysC testing and of patients who underwent rapid cysC testing at Mayo Clinic between January 1, 2011, and March 31, 2018, were described. Poisson regression analyzed temporal trends in cysC testing. Results: Of the 114 hospitals (88%) that responded to the statewide survey, cysC was available in 91 (80%), but only 3 of 91 (3%) reported a turnaround time of <1 day. At Mayo Clinic, cysC use increased from 0.74 tests per 1000 patient-days in 2011 to 14 tests per 1000 patient-days in 2018 (P=.004). Of the 3774 patients with cysC tests, the mean first available eGFR was 46 mL/min per 1.73 m2 using cysC and 59 mL/min per 1.73 m2 using serum creatinine (P<.001). CysC testing was used across all intensities of care and was ordered by a variety of specialties. Nephrology was consulted in only 42% of cases. Conclusion: In the hospital, rapid-turnaround cysC testing is necessary for practical use but was not widely available in Minnesota. When available, a marked increase in cysC testing was observed over the study timeframe. Additional research is needed to determine optimal strategies for implementation of cysC within hospitals.
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U2 - 10.1016/j.mayocp.2020.03.030
DO - 10.1016/j.mayocp.2020.03.030
M3 - Article
C2 - 32753139
AN - SCOPUS:85088626661
SN - 0025-6196
VL - 95
SP - 1649
EP - 1659
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 8
ER -