怀化市第一人民医院2014年急诊重症监护病房疾病构成分析

Analysis on disease constitution of emergency intensive care unit in 2014

目的：分析我院2014年急诊重症监护病房（EICU）疾病构成,为科学规划我院EICU用药及医疗资源配置提供基线数据。方法：回顾性分析我院2014年633例EICU患者的年龄与性别构成、系统疾病构成、平均住院日、人均总费用与药占比、疾病转归、前8单病种的性别构成及年就诊规律。结果：1EICU患者主要集中在19~74岁,男性患者多于女性患者;2损伤、中毒和外因的某些其他后果位列EICU主要系统疾病构成第1,循环系统疾病、消化系统疾病及呼吸系统疾病分列第2、3和4;3EICU平均住院天数为4.3d,人均总费用为6316.80元,药占比为50.09%;4转归：专科病房（35.07%）、急诊普通病房（22.91%）、出院（18.96%）、死亡（15.32%）、中心ICU（5.53%）、转院（2.21%）;5前8位单病种依次为蛇咬伤、中毒、多发性创伤、冠心病、慢性阻塞性肺疾病（COPD）、其次为上消化道出血、酮症酸中毒及急性胰腺炎,蛇咬伤具有明显的年就诊规律。结论：中毒、蛇咬伤与慢病急危重症为我院EICU主要疾病构成;患者病死率较高,需加强急诊人才培训与急救设备配置,提高救治水平。

Objective：To provide baseline date for further research by analyzing the disease constitution of our hospital in 2014.Method：The information of 633 cases of emergency intensive care unit（EICU）in 2014 was extracted from HIS and their main diagnosis were classified by ICD-10.Retrospectively study on system disease and single disease,age,gender,outcome,average length of stay,hospital cost,drug cost proportion and regularity of medical visits.Result：The analysis results showed that：1 Most EICU patients were concentrated in the 19~74years old,and more male than femal.2According to ICD-10,S00-T98 ranked 1,and I00-I99,K00-K93,J00-J99 ranked 2,3,4.3The average length of stay is 4.3days,average hospital cost is 6316.80 yuan,and the drug cost proportion is about 66.80%.4Outcomes of EICU patients in 2014 follows on：specialized wards（35.07%）,emergency wards（22.91%）,discharge（18.96%）,death（15.32%）,ICU（5.53%）,transfer（2.21%）.5The top 8single diseases were snakebite,toxicosis,multiple trauma,coronary heart disease,chronic obstructive pulmonary disease,diabetic ketoacidosis,upper gastrointestinal hemorrhage,acute pancreatitis,and however,the medical visits of snakebite has obvious regularity.Conclusion：Snakebite,toxicosis and chronic diseases were the major diseases in EICU in 2014.Mortality was high and we should further impove success rescue rate of emergency treatment.