Back
Intradialytic hypotension (IDH) is a common and serious complication of chronic dialysis treatment, with long-term consequences such as increased cardiovascular and all-cause mortality. The BestShape, an artificial intelligence-driven system for real-time intradialytic hypotension prediction, was previously developed. This study aimed to demonstrated the preliminary clinical results and health economic benefits following the incorporation of the BestShape in medical institutions across Taiwan.
This is a retrospective study. From January 1, 2020, two medical institutions in Taiwan (Mackay Memorial Hospital Taipei and Tamshui branches) incorporated BestShape into all hemodialysis (HD) sessions. The Vital Info Portal (VIP) gateway, connected to the HD device, collected the parameters in each HD session. The data from consecutive HD sessions spanning from January 2020 to September 2023, following the implementation of BestShape, constituted the observational group. The data retrieved from January 2019 through the end of 2019 served as the historical control group. The primary outcome was the frequency of IDH, and the secondary outcomes were the rates of cardiopulmonary resuscitation (CPR), fall, and providers’ satisfaction, mortality rates, and estimated total cost reduction.
A total of 104,117 HD sessions during the study period were included (observational group: 66,683; control group: 37,434 sessions) for analyses. The monthly average IDH rates decreased significantly from 27.4% to 20.3% (p<0.05) after incorporation of BestShape. The occurrences of CPR during dialysis decreased from 5 to 3 times, resulting in an estimated total cost reduction of 47 thousand USD annually. In addition, post-dialysis falls decreased from 5 to 1 times. The mortality rates during the HD sessions prior to (2017-2019) BestShape implementation were 8.3%, and 10.6% afterwards (2020-2022), with no statistically significant differences. The medical staff expressed significant satisfaction with BestShape, as evidenced by average satisfaction scores of 86.5 and 85.5 in Tamshi and Taipei branch, respectively.
This study presents the initial outcomes of incorporating BestShape within Taiwanese hospitals, revealing a high level of satisfaction among medical staff and achieving notable reductions in IDH, CPR incidents, and falls. These improvements hold the potential for substantial reductions in healthcare costs.