2007—2011年北京市先天性心脏病患者住院病死率趋势研究

In-hospital case-fatality rate among patients admitted for congenital heart disease in Beijing during 2007-2011

目的:分析2007—2011年北京市先天性心脏病(CHD)患者住院病死率及其变化趋势。方法:CHD病例数据来源于北京市出院患者信息系统。CHD的住院病死率指住院期间因CHD死亡的患者占所有CHD住院患者的比例。结果:2007—2011年,北京市主要出院诊断为CHD的住院患者共53 064例,平均住院病死率为1.50%。在各年龄组中,<1岁组CHD的住院病死率最高(3.75%)。重症CHD的住院病死率高于非重症CHD(3.49%vs.1.05%,P<0.001)。心血管重点三级医院的住院病死率显著低于非心血管重点医院(包括二级医院和其他三级医院;P<0.001)。年龄标化后,5年CHD住院病死率呈显著下降趋势(P<0.001),由2007年的2.37%降至2011年的1.02%,降低了56.8%。结论:5年间,北京市CHD住院病死率总体呈下降趋势,提示北京市CHD住院期间的医疗救治水平整体提高。

Objective： To examine the trends of in-hospital case-fatality rate of congenital heart disease （CHD）in Beijing from 2007 to 2011. Methods： Data from the Hospital Discharge Information System were used to identify all patients who were hospitalized with the primary discharge diagnosis of CHD, coded as Q20 to Q26 （ICD-10） , during Jan. 1, 2007 to Dec. 31, 2011 in Beijing. The in-hospital case-fatality rate of CHD was calculated and the trends over years were examined. Direct age standardization was performed, taking the overall hospital admissions for CHD from 2007 to 2011 as the reference population. The comparison between groups was performed using ,2 test. Results： Totally 53 064 patients with the primary discharge diagnosis of CHD were identified during 2007 to 2011 in Beijing. The overall in-hospital case-fatality rate of CHD during the study period was 1.50%, and the rate was higher in patients younger than 1 year old than that in other age groups, higher for severe CHD than that for non-severe CHD （3.49% vs. 1.05% , P 〈0. 001 ） , higher in patients admitted in non-cardiac specific hospital than that in cardiac specific tertiary hospitals （3.67% vs. 1.01% , P 〈 0. 001 ）. Age-standardized in-hospital ease-fatality rate decreased from 2. 37% in 2007 to 1.02% in 2011, representing a 56. 8% decline（61.5% in males and 53.9% in females）. Conclusions： The recent in-hospital case-fatality rate for CHD demonstrated a significant declining trend during 2007 to 2011 in Beijing, indicating the improvement in the in-hospital treatments of CHD. Differences in in-hospital case-fatality rate exist among CHD patients with different characteristics. These findings may guide future health care planning and help to determine priorities for clinical treatment.