心内科住院患者死亡相关因素分析

Analysis of death related factors of inpatients in department of cardiology

目的分析心内科住院患者死亡相关因素,了解心内科死亡常见和少见病种。方法收集2005年1月1日至2015年1月1日大连医科大学附属第一医院心内科720例死亡病例的临床资料。按死亡时间分为A组(前5年)和B组(后5年),对两组一般情况(性别、年龄、心率)、直接死因(主要分析慢性心衰及猝死)、死亡基础病因(冠心病、瓣膜病、高心病、肺心病)等因素进行分析。结果 B组与A组比较,住院患者总体死亡率明显下降,死亡年龄逐渐增大,女性死亡率呈明显上升趋势。心率≥80次/min患者死亡率明显高于心率<80次/min者。心衰尤其是慢性心衰是心内科住院患者直接死亡的原因。冠心病仍为主要死因,冠心病尤其急性心梗是导致心源性猝死的重要原因。结论在临床工作中,应密切关注心血管病患者的心率变化。慢性心衰及冠心病仍是心内科疾病死亡重要原因。

Objective To analyze the death related factors of hospitalized patients in Department of Cardiology, and to understand the common and rare diseases in the Department of Cardiology. Methods We retrospectively reviewed 720 cases of death in the Department of Cardiology at the First Affiliated Hospital of Dalian Medical University from January 1,2005 to January 1,2015. According to the time of death, the patients were divided into group A （five years before） and group B （5 years after）. General information （gender, age, heart rate）, direct cause （mainly the analysis of chro- nic heart failure and sudden death） , death of underlying disease （coronary heart disease, valvular heart disease, con- genital heart disease, pulmonary heart disease）and related factors were analyzed and compared. Results Compared with group A, hospitalized patients in group B had overall decreased mortality significantly, gradually increased death age, significantly increased mortality rate in women. The heart rate was an risk factor for cardiovascular disease. Heart fail- ure, especially chronic heart failure was direct cause of death in inpatients in the Department of Cardiology. Coronary heart disease was the main cause of death. Coronary heart disease, especially acute myocardial infarction was the cause of the important factors of cardiac death. Conclusion Heart rate is an independent factors of cardiovascular disease and should be payed close attention to in clinical work. Chronic heart failure and coronary heart disease are important causes of death in the Department of Cardiology, which can not be ignored.