“The three-year randomized study shows the benefits of the THO ePRISM platform to strategically target the high-risk portion of the population. For many cardiovascular service line programs, the rate of reduction in AKI shown in this study, using ePRISM technology, can improve their hospitals’ quality performance metrics from middle to top decile. This can result in lower costs to the hospital and better outcomes for patients,” said Michael J. Martinelli, MD, FACC, FSCAI and Chief Medical Officer, Terumo Medical Corporation.
“Contrast-associated AKI is the most common complication of coronary angiography and PCI, and contributes to higher costs for healthcare systems and negative outcomes for patients,” said John A. Spertus, MD, MPH, Professor of Medicine at the University of Missouri-Kansas City and co-author of the study. “By incorporating ePRISM to define ‘safe’ contrast limits for each individual patient, coupled with protocol-driven hydration, physicians were able to deliver much safer care. Using tools like ePRISM to improve outcomes represents the future of precision medicine in routine clinical practice."
ePRISM uses the most valid risk model available to predict – on an individual basis – patients’ risks for AKI and establishes patient-specific contrast limits to help guide safer PCI. Armed with this knowledge, clinicians can make informed, pre-procedure treatment decisions and modify their approaches during treatment to minimize risk and improve outcomes.
“This study further underscores how Terumo Health Outcomes’ unique approach to partnering with healthcare systems to achieve optimal performance – by prospectively incorporating CDS tools like ePRISM into clinical workflows and providing feedback – can be a differentiated and impactful way to drive quality and efficiency into healthcare,” added Ryan Graver, Divisional Vice President, Terumo Health Outcomes.
The study participants included 31 invasive cardiologists from three cardiac catheterization laboratories in Alberta, Canada. Physicians performed 7820 procedures among 7106 patients who had a predicted AKI risk of greater than 5%. When ePRISM was used, the proportion of procedures exceeding the safe contrast limits was reduced from 51.7% to 38.1%.
During the intervention period, cardiologists received educational outreach, computerized CDS on contrast volume and hemodynamic-guided intravenous fluid targets, and audit and feedback. During the control period, cardiologists provided usual care and did not receive the intervention training or tools. The primary outcome was AKI. There were 12 secondary outcomes, including contrast volume, intravenous fluid administration, and major adverse cardiovascular and kidney events. The analyses were conducted using time-adjusted models.
About Terumo Health Outcomes
About Terumo Medical Corporation
Terumo (TSE: 4543) is a global leader in medical technology and has been committed to “Contributing to Society through Healthcare” for 100 years. Based in Tokyo and operating globally, Terumo employs more than 30,000 associates worldwide to provide innovative medical solutions in more than 160 countries and regions. The company started as a Japanese thermometer manufacturer, and has been supporting healthcare ever since. Now, its extensive business portfolio ranges from vascular intervention and cardio-surgical solutions, blood transfusion and cell therapy technology, to medical products essential for daily clinical practice such as transfusion systems, diabetes care, and peritoneal dialysis treatments. Terumo will further strive to be of value to patients, medical professionals, and society at large.