Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods...Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time展开更多
Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppressio...Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.展开更多
文摘Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time
文摘Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.
文摘目的基于疾病诊断相关分组(diagnosis-related groups,DRG)分析北京市某三级综合医院住院死亡病例情况,以期为医疗质量管理提供参考依据。方法回顾性收集北京市某三级综合医院2015年1月1日—2023年12月31日DRG入组住院患者数据,以死亡风险分级为标准进行住院死亡病例分析,重点探讨低/中低风险组死亡病例的时间分布趋势、科室来源、DRG构成等。结果该院DRG共入组住院患者927304例,住院死亡患者2346例(低、中低、中高、高死亡风险组分别为130例、209例、411例、1596例),住院总死亡率为0.25%。DRG入组病例中,低死亡风险组死亡率为0.02%(130/680939),中低死亡风险组死亡率为0.16%(209/130449),2015—2023年入组病例死亡率整体呈下降趋势(χ^(2)=104.77,P<0.001)。低/中低风险死亡病例主要来自内科重症监护病房(medical intensive care unit,MICU)和ICU(37.8%,128/339)。全部死亡病例最多的DRG组为RW29,低/中低风险死亡病例最多的DRG组为EC13(结核,手术室手术,伴并发症与合并症),居前3位的主要诊断依次为C34.101(肺上叶恶性肿瘤)、J18.903(重症肺炎)、J15.600x005(鲍曼不动杆菌性肺炎)。结论重症监护病房为该院死亡病例最多的科室,患者手术伴并发症与合并症可能是低/中低风险死亡的主要DRG相关因素。医院应予以高度重视,识别优化薄弱环节,推动死亡病例多学科讨论,以充分保障患者安全。
