81例骨科死亡病例分析与对策

Analysis and Countermeasure of 81 Deaths of Orthopaedic

目的:分析骨科住院死亡病例的临床特点、死亡原因、主要合并症和导致死亡发生的高危因素,探讨性提出降低骨科住院病人死亡发生率的对策。方法:采用回顾性研究的方法,对2000年1月1日-2011年12月31日中国中医科学院望京医院骨科住院死亡病例进行检索分析。结果:81例死亡病例平均年龄67.2±10.9岁,因外伤入院者56例,骨折50例,其中股骨粗隆间骨折25例,股骨颈骨折13例。主要合并症顺位为呼吸系统疾病、心血管系统疾病、电解质紊乱等。死亡原因顺位为呼吸衰竭、多脏器功能衰竭、急性脑血管病等。结论:本组死亡病例中老年患者占多数。髋部骨折患者是死亡病例中最常见的人群。骨科死亡病例多合并多种内科疾病,其中以呼吸系统疾病最为常见。肺栓塞是导致骨科病人死亡的高危因素,是严重的并发症之一,对于髋部骨折的患者尤其应加以预防。

Objective：To analyze clinical features, cause of death, major complications, and risk factors leading to death occurred of inpatient, and to explore the countermeasures for decreasing the death incidence of orthopedic inpatient. Methods： A retrospective study was used to retrieval analyze the clinical data of deaths of orthopedics wards in WangJing Hospital from January 1, 2000 to December 2011. Results：The average age of 81 deaths was 67.2%10.9 years old. There were 56 cases of trauma （50 cases of fracture, 25 cases of intertrochanteric fracture, and 13 cases of femoral neck fracture）. The major complications were respiratory diseases, cardiovascular diseases, electrolyte imbalance, and so on. The causes of death were respiratory failure, multiple organ failure, acute cerebrovascular disease, and so on. Conclusion：The deaths are majority in elderly. Patients with hip fracture are the most common deaths crowd. The cases of orthopedics death were of- ten combined with multiple medical diseases, especially with respiratory disease. Acute pulmonary embolism is the risk factor leading to death, it is one of the serious complications, and it should be prevented especially in patients of hip fracture.