1.Establishment and analysis of an early prognosis model of patients with acute kidney injury in intensive care unit
Yu'an GENG ; Congmei WANG ; Zhijing XU ; Lu QI ; Yangang SHI ; Shiqiong SU ; Kai WANG ; Ruifang LIU
Chinese Critical Care Medicine 2024;36(2):178-182
Objective:To establish a predictive model for the progression of acute kidney injury (AKI) to stage 3 AKI (renal failure) in the intensive care unit (ICU), so as to assist physicians to make early and timely decisions on whether to intervene in advance.Methods:A retrospective analysis was conducted. Thirty-eight patients with AKI admitted to the intensive care medicine of the Third People's Hospital of Henan Province from January 2018 to May 2023 were enrolled. Patient data including acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) upon admission, serum creatinine (SCr), blood urea nitrogen (BUN), daily urine output during hospitalization, and the timing of continuous renal replacement therapy (CRRT) intervention were recorded. Based on clinically collected pathological data, standardized creatinine value ratio mean polynomial fitting models were established as the first criterion for judging the progression to stage 3 AKI after data cleansing, screening, and normalization. Additionally, standardized creatinine value ratio index fitting models were established as the second criterion for predicting progression to stage 3 AKI.Results:A total of 38 AKI patients were included, including 25 males and 13 females. The average age was (58.45±12.94) years old. The APACHEⅡ score was 24.13±4.17 at admission. The intervention node was (4.42±0.95) days. Using a dual regression model approach, statistical modeling was performed with a relatively small sample size of statistical data samples, yielding a scatter index non-linear regression model for standardized creatinine value ratio data relative to day " n", with y = 1.246?2 x1.164?9 and an R2 of 0.860?1, indicating reasonable statistical fitting. Additionally, a quadratic non-linear regression model was obtained for the mean standardized creatinine value ratio relative to day " n", with y = -0.260?6 x2+3.010?7 x-1.612 and an R2 of 0.998?9, indicating an excellent statistical fit. For example, using a baseline SCr value of 66 μmol/L for a healthy individual, the dual regression model predicted that the patient would progress to stage 3 AKI within 3-5 days. This prediction was consistent when applied to other early intervention renal injury patients. Conclusion:The established model effectively predicts the time interval of the progression of AKI to stage 3 AKI (renal failure), which assist intensive care physicians to intervene AKI as early as possible to prevent disease progression.
2.Analysis on the current monitoring and management of blood donation adverse reaction in Chongqing
Binglingyi HU ; Junhong YANG ; Zaiyun CHEN ; Mingxiu WANG ; Chengyi HU ; Congmei ZHANG ; Jie SHI ; Xia HUANG ; Tao HE
Chinese Journal of Blood Transfusion 2021;34(12):1282-1285
【Objective】 To investigate the management of adverse reactions to blood donation(ARBD) in blood services, so as to promote the surveillance of ARBD and improve the quality of blood donation service in Chongqing. 【Methods】 A questionnaire, involving the staff and facilities in blood donation sites as well as the prevention and treatment, the record and report, the following up and data related to ARBD was developed by Chongqing Society of Blood Transfusion in February 2019, and was issued to 18 blood services(1 blood center and its sub-center, 6 central blood stations and 11 hospital blood banks) in the Chongqing via email. The questionnaire was filled in and submitted before March 31 by management personnel participating in the investigation, and the data was collected, collated, revised and analyzed by Excel 2011. 【Results】 A total 19 questionnaires were collected, with the valid rate at 100%(19/19). 78.95%(15/19) of the blood services met the requirements of medical personnel allocation(>6 medical staff) when the number of daily blood collection was more than 60, and 100%(19/19)met the requirements of medical personnel allocation(2 to 6 medical staff) when the number of daily blood collection was less than 60. 89.47%(17/19) of the blood services were equipped with epinephrine hydrochloride, and 84.21%(16/19) with dexamethasone(an anti-allergic drug). There were significant differences in the allocation of other types of drugs. 100.00%(19/19) of the blood services formulated prevention and treatment measures concerning ARBD. In 2019, the incidence of ARBD in Chongqing was reported to be 0.54%(1 958 / 359 871), with the highestas [1.35%(223/16 543)] in subcenters and the lowest [0.32%(179/56 299)] in central blood centers (P<0.05). There was statistical significances in the incidences of ARBD reported by different blood stations(P<0.05). 【Conclusion】 The monitoring and management of ARBD among blood services in Chongqing should be further standardized in terms of staffing allocation, emergency drugs allocation and reporting, so as to gradually realize regional homogenization and ensure blood safety.