MORTALITY AND MORBIDITY

CONFERENCE
Service Census
APRIL 2019

Thara C. Villegas, MD/ Leigh Cruz-Salinas, MD

 April April
Variance
2018 2019
Service 39 31 -20%
Ward
38 31 -18%
admissions
ER admissions 1 0 100%
Referrals 4 0 100%
Mortality 1 0 100%
HAMA 0 0 0
Re-admission 0 3 0
 TOP 3 QFS
Total
Patient Diagnosis Duration Hospital QFS PHIC Payment
Charges

AKI (F) 2 to
RPGN sec PSGN
RHD
Sepsis, HAP
156,400.7 120,890.7
PD 2F s/p PDCI 18 3 3
13,510 7000
PD Migration
s/p PDCR
s/p 1 aliquot
pRBC
 TOP 3 QFS
Total
Patien
Diagnosis Duration Hospital QFS PHIC Payment
t
Charges

Chronic Kidney
Disease V sec to
Chronic GN On
JDR HD
13.50
135,983.6 114,583.6
21,400 0
16M Renal Anemia 2 2
s/p IJCI
s/p PDCI
s/p 3 U pRBC
 TOP 3 QFS
Total
Patient Diagnosis Duration Hospital QFS PHIC Payment
Charges
CKD V 2 to
Obstructive
Uropathy
Bladder Outlet
Obstruction
Multiple Congenital
anomalies
MJP (Hypospadias,
10M Imperforate anus 6.5 65,412.33 55,262.33 10,150 0
s/p Colostomy
(2009)
Cystitis
Pneumonia
Renal Anemia
Malnutrition
s/p 1 U pRBC
 TOP 3 CASES
NUMBE
R PERCENTAG
CASES
OF E
CASES
Chronic Kidney Disease 11 35%
Nephrotic Syndrome 4 12%
AGN 3 9%
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

CHRONIC KIDNEY DISEASE - INITIATION (n=2)

Chronic Kidney Disease
V sec to Chronic GN On
HD
Renal Anemia 14 1 1
s/p IJCI
s/p PDCI
s/p 3 U pRBC
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

CHRONIC KIDNEY DISEASE - INITIATION (n=2)

CRBSI #1
Chronic Kidney Disease
V sec to Chronic GN on
HD 7 1 1
s/p IJCR
s/p IJCI & PDCI
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

AGE with some

dehydration
3 1 1
CKD V sec to CGN on HD
HPN Stage II

PD Peritonitis #1
CKD V sec to CGN on CAPD 4 1 1
Dilated Cardiomyopathy
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Pulmonary Congestion sec to

CHF, LV Dysfunction
CKD V sec to Hypoplastic kidneys 4 1 1
on HD
s/p Intubation and extubation
Pulmonary Congestion due to
fluid overload 7 1 1
CKD V sec to CGN on HD
CKD V sec to Obstructive
Uropathy, Bladder Outlet
Obstruction, MCA (Hypospadias,
Imperforate anus s/p colostomy 9 1 1
2009); UTI; Pneumonia; Renal
Anemia; Malnutrition; s/p 1 U
pRBC
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

CKD V sec to Hypoplastic

Kidneys on HD
5 1 1
LV dysfunction
s/p IJCI
HPN Stage II
Hypertensive Retinopathy
CKD V sec to CGN on CAPD 7 1 1
Renal Anemia
s/p 2 U pRBC
HPN Stage II
7 1 1
CKD V sec to CGN on HD
 CHRONIC KIDNEY DISEASE (n=11)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Hypotensive Shock sec

to Severe Dehydration
Pneumonia 5 1 1
CKD V sec to CGN on
CAPD
 ACUTE KIDNEY INJURY (N=2)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

AKI (F) sec to RPGN, 6 1 1

PSGN (Scarlet Fever)
AKI (F) 2 to RPGN sec
PSGN RHD
Sepsis, HAP
s/p PDCI 19 1 1
PD Migration
s/p PDCR
s/p 1 aliquot
pRBC
 NEPHROTIC SYNDROME (N=4)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Nephrotic Syndrome
5 1 1
s/p Albumin x 2 vials
Nephrotic Syndrome
Pneumonia
3 1 1
Blepharitis, bilateral
s/p Albumin x 1 vial
Atypical Pneumonia, BAIAE
NS, Immune Complex GN, 6 1 1
in relapse
 NEPHROTIC SYNDROME (N=4)

29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Nephrotic Syndrome in
Relapse 2 18 1
s/p Albumin x 2 vials
 URINARY TRACT INFECTION (N=1)

29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Acute Pyelonephritis
with some 7 1 1
dehydration
VUR Grade 4, Left
 POST-KIDNEY TRANSPLANTATION (N=1)

29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Mixed Cellular Antibody mediated

rejection
s/p Renal Allograft Transplantation,
LRD (2/19/18)
s/p UTZ-guided kidney biopsy
(11/12/18; 1/22/18)
7 1 1
s/p IV Medrol x 5 (11/2018)
s/p RATG x 5 doses (12/2018)
s/p IVIG (3/2019)
s/p IVIG (4/2019)
 POST-KIDNEY TRANSPLANTATION (N=1)

29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Febrile Neutropenia
Stomatitis
Mixed Cellular Antibody mediated
rejection
s/p Renal Allograft Transplantation,
LRD (2/19/18)
s/p UTZ-guided kidney biopsy
7 1 1
(11/12/18; 1/22/18)
s/p IV Medrol x 5 (11/2018)
s/p RATG x 5 doses (12/2018)
s/p IVIG (3/2019)
s/p IVIG (4/2019)
 IV PULSING (N=2)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

DPGN with Crescents

s/p IV Medrol x 3 doses 3 1 1
(2nd cycle)

IgA Nephropathy
s/p IV Medrol x 3 doses 3 1 1
(2nd cycle)
 KIDNEY BIOPSY (N=7)

29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Nephrotic Syndrome,
Steroid Dependent, in
Remission 3 1 1

Biopsy result: MGA

 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Persistent Microscopic
Hematuria
3 1 1

Biopsy result: MGA

 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Nephrotic-Nephrotic
Syndrome

Biopsy result: FSGS with 8%

3 1 1
segmental
glomerulosclerosis (2 of 25
glomeruli); Mild Interstitial
and Tubular Atrophy
 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Persistent Microscopic
Hematuria

Biopsy result:
IgA Nephropathy; Mild
3 1 1
Interstitial Fibrosis and
tubular atrophy with 12%
Global Glomerulosclerosis
(4 of 25 glomeruli); Mild
Arteriosclerosis
 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

NNS

Biopsy result: Lupus

Nephritis with activity
index of 1 and chronicity
index of 2 with 4% 3 1 1
segmental
glmerulosclerosis (2 of 50
glomeruli); Mild
insterstital fibrosis and
tubular atrophy
 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Lupus Nephritis

Biopsy result: Lupus

3 1 1
Nephritis Class V with
activity index of 0 and
chronicity index of 0
 KIDNEY BIOPSY (N=7)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

Persistent Microscopic
Hematuria

Biopsy result: MGA with 3 1 1

6% Global
Glomerulosclerosis (3 of 51
glomeruli)
 ACUTE GLOMERULONEPHRITIS (N=3)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o

HPN Stage II 3 1 1
PSGN

HPN Stage II 5 1 1
PSGN

HPN Stage II 4 1 1
PSGN
 REFERRAL (N=0)
29
DAYS
0-28 days 1-4 5-9 10-14 >15
SERVICE ADMIT-
days - y/o y/o y/o y/o
TOTAL
TED
1y/o
Thank
You !!!