基于住院病案首页的慢阻肺患者住院人数影响因素分析

Analysis of Influencing Factors for Hospitalization of COPD Patients Based on Hospital Discharge Data

目的探讨慢性阻塞性肺疾病(慢阻肺)住院人数的时间变化趋势及其与空气质量的关系。方法收集大连市2002年-2015年所有二级及以上医院的住院病案首页数据,分析不同性别、年龄、合并症程度的慢阻肺患者住院人数时间趋势,以及住院人数与当地空气质量的关系。结果不同性别、年龄、合并症程度的慢阻肺患者住院人数均呈增长趋势,男性患者、60岁及以上患者、无合并症患者住院人数的增长明显高于相应其他人群;慢阻肺住院人数随季节更替有明显变化,春冬两季住院人数高于夏秋两季;随着空气质量的变差,2002年-2007年、2008年-2012年、2013年-2015年间慢阻肺住院人数均有显著上升趋势,P值分别为<0.001、0.040和<0.001。结论应提高对男性及老年人群的慢阻肺防治力度,并加强对慢阻肺合并症的治疗。春冬两季是慢阻肺的高发季,应重点监测预防,保护易感人群。积极改善空气质量控制污染,减少慢阻肺的住院人数。

Objectives To explore the temporal trend of hospitalization of patients with chronic obstructive pulmonary disease（COPD） and the relationship between the hospitalization and air quality. Methods Hospital discharge data for the period 2002–2015 were collected from all hospitals in Dalian, China. Analyzing the time trend of hospitalization of patients with COPD and the relationship between hospitalization and the local air quality stratified by sex, age and comorbidity. Results The number of hospital discharges with COPD as the primary diagnosis increased annually stratified by sex, age and comorbidity. The number of discharges for male patients,patients aged ≥ 60 years old, and patients without comorbidities were higher than those for female patients,patients at other ages, and patients with mild or server comorbidities, respectively. The number of hospitalized patients with COPD changed with the seasons. It was higher in winter and spring than that of summer and autumn.With the deterioration of air quality, the number of hospitalized patients with COPD increased significantly between 2002 and 2007, 2008 and 2012, and 2013 and 2015,P〈0.001, P=0.040, and P〈0.001, respectively.Conclusions It is necessary to strengthen the prevention and treatment in the male and elderly population and patients with comorbidities, especially in spring and winter. More efforts should be made to improve the air quality and therefore reduce the number of patients with COPD.