单中心10年急诊死亡患儿临床研究

Death of children in the emergency department: a single-center clinical analysis in 10 years

目的分析急诊死亡患儿的流行病学特点,了解引起儿童急诊死亡的主要疾病谱及其变化趋势。方法回顾性分析2005-2014年重庆医科大学附属儿童医院1 115例急诊死亡病例资料,在城乡分布、年龄、性别、入院死亡时间、死亡地点、季节及原发疾病等方面进行统计分析。结果急诊死亡患儿男女比例为157∶100,农村患儿明显多于城市患儿(城乡比例为1∶2.64)。到院前死亡(death on arrival,DOA)占8.07%。新生儿死亡占37.49%,婴儿占26.10%,≤1岁死亡患儿高达63.59%,是急诊死亡患儿的主要年龄层。急诊死亡患儿以每年1月为高发季节(占13.63%)。急诊死亡前5位疾病分别为肺炎(14.71%)、先天性心脏病(10.40%)、呼吸窘迫综合征(9.24%)、意外伤害(8.70%)和窒息(误吸)(5.11%)。因此呼吸系统疾病占急诊死亡病例的23.95%。近年因意外伤害、手足口病死亡的患儿呈上升趋势。结论 1岁以内患儿是小儿急诊死亡的高危人群,呼吸系统疾病是患儿急诊死亡的主要病因。

Objective To analyze epidemiological characteristics of death of children in emergency department and find out the major diseases and the variation trend. Methods From January 2005 and December 2014, the data of 1 115 cases of emergency death of children in Children＇s Hospital of Chongqing Medical University were sorted and retrospectively analyzed, including urban and rural distribution, gender and age, time and place of death, and season and primary diseases. Results The death ratio of boys to girls was 157： 100, and the urban-to-rural ratio of emergency death was 1： 2.64. Dead on arrival （DOA） amounted for 8.07%, and neonates and infants accounted for 37.49% and 26.10%, respectively. The data showed that the mortality of emergency cases was very high in the patients younger than 1 year of age （63.59%）, and emergency death happened frequently in each January （ 13.63% ）. Additionally, pneumonia （ 14.71% ）, congenital heart disease （10.40%）, acute respiratory distress syndrome （9.24%）, accident （8.70%） and asphyxia （aspiration） （5. 11% ） were the top 5 causes of death, which indicated that respiratory system disease （total 23.95% ） was the primacy factor. Significantly, the mortality caused by accidents and hand- foot-and-mouth disease （HFMD） presented an ascending trend in recent 10 years. Conclusion The probability of emergency death is the highest in the infants younger than 1 year old, and respiratory system disease is the leading cause of emergency death.