北京青年急性冠心病事件院前死亡流行病学研究

The epidemiology of out-of-hospital deaths due to acute coronary events in young Beijing adults

目的研究北京地区青年人群急性心血管事件院前死亡的现状及在不同特征人群中的特点。方法以北京市公共卫生信息中心的“北京市出院病人信息系统”以及北京市疾病预防控制中心的“北京市死因监测系统”这两个政府常规卫生信息系统为基础，获得并分析25～45岁年龄组不同性别、不同区县、不同职业、不同婚姻状况的人群中，急性冠心病事件的总病死率和院前死亡构成。结果2007--2009年北京地区25～45岁急性冠心病事件共3489例（男3183例，女306例），年龄（40．5±4．3）岁。总病死率3年合计为26．O％，女性明显高于男性（51．0％比23．6％，P〈0．05），郊区和农村地区的总病死率高于城区（28．9％比22．9％，P〈0．05）。25～45岁急性冠心病事件院前死亡在总死亡中的比例3年合计为95．0％（男95．2％，女94．2％），个体经营者的院前死亡在总死亡中的比例最高，为98．6％。64．8％的院前死亡发生地点在家中。结论北京地区25—45岁急性冠心病事件的死亡90％以上发生于院前，死亡地点主要发生在家中。

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing. Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing. The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease （CHD） death were compared upon gender, area, occupation and marital status among people aged between 25-45 years old. Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events （ male ： 3183, female ： 306 ）, with a mean age of （ 40.5 ± 4.3 ） years old. The 3- years＇ overall mortality was 26. 0% , with female＇s higher than male＇s （51.0% vs 23.6% , P 〈0.05） ; and it was higher in rural area than in urban areas （28.9% vs 22. 9% , P 〈 0. 05 ）. Ninety-five percent of death clue to acute coronary events occurred prehospital, with the proportion of 95.2% in male and 94.2% in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death. Majority of prehospital deaths （64. 8% ） occurred at home. Conclusion More than 90% of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital, and the site of prehospital deaths was mainly at home.