老年住院患者死亡时间研究

Analysis on the death time of elderly hospitalized inpatients

目的了解老年住院死亡患者的死亡情况及时间节律分布，提出预见性医疗对策。方法收集首都医科大学附属北京友谊医院老年医学科2009年8月至2013年8月60岁及以上老年住院死亡患者449例的病历资料，分析患者死亡的季节及时间分布规律。结果肺部感染（175例，38．97％）和恶性肿瘤（162例，36．08％）是导致死亡的最主要原因。春季和夏季肺部感染的死亡人数较高，夏季恶性肿瘤相关死亡人数较高，但差异无统计学意义（均P〉0．05）。心脑血管系统患者死亡时间高峰出现在23时至7时（χ^2=11．10、14．19，均P〈0．05）。结论老年住院患者的主要死亡原因是肺部感染及肿瘤，心脑血管患者的死亡高发时段为下半夜。

Objective To examine the time patterns and seasonality of death of hospitalized elderly patients and to propose proactive management measures. Methods Data were collected on 449 patients aged 60 years and over who had died between August of 2009 to August of 2013 during hospitalization at the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University. The seasonality and time patterns of the patients＇ deaths were analyzed retrospectively. Results Pulmonary infections（175 cases,38.97%）and malignant tumors（162 cases,36.08%）were the leading causes of death. Deaths from pulmonary infections were more frequent in spring and summer while deaths caused by malignant tumors were more frequent in summer, but the differences were not statistically significant（all P〉0.05）. The peak times of death in patients with cardiovascular and cerebrovascular disease were between 23 ： 00 pm to 7 ： 00 am（χ^2= 11.10 and 14.19, respectively, P〈 0.05）. Conclusions Pulmonary infections and malignant tumors are the main causes of death in elderly inpatients, which most often occurs during the latter half of the night in patients with cardiovascular and cerebrovascular diseases.