某院2015年-2017年入院24小时内死亡病例数据分析

Statistical Analysis on Death Cases Admitted into a Hospital within 24 Hours from 2015 to 2017

目的分析某医院入院24小时内死亡病例,为医院质量管理提供数据。方法从病案系统和北京地区住院医疗服务绩效评价平台中收集2015年1月1日-2017年12月31日期间110例入院24小时内死亡患者的病例信息,统计年龄、性别分布、收治科室、死亡风险分级、CMI及死因顺位等。结果分析入院24小时内死亡病例共110例,其中男性患者72人,女性患者38人,男女比例1.89:1;死亡年龄为0岁～98岁,平均年龄61.6±26.0岁,中位数年龄为65.5岁,男性患者集中在60岁～70岁年龄组,女性患者集中在80岁～90岁年龄组。入院24小时内死亡病例的前3位科室是心内科、急诊科和重症医学科,75.23%的病例属于高风险组。入院24小时内死亡病例的CMI值为2.3552±1.7481,低于非入院24小时内死亡病例2.9750±2.5134,并且高于非死亡病例0.9709±0.8936。结论中老年男性患者是医院入院24小时内死亡的高发人群,应作为重点防治人群。入院24小时内死亡病例可作为医院质量与安全监测与缺陷管理的重点,促进医疗质量持续改进。

Objectives To analyze the deaths within 24 hours of hospital admission in 3 years and provide data for hospital quality management. Methods The data of deaths within 24 hours from January 1, 2015 to December 31, 201 were collected from the medical record system and Beijing hospitalization medical service performance evaluation platform. The data were analyzed for age, gender distribution, treatment of departments, risk grade of death, CMI and rank of cause of death. Results A total of 110 deaths within 24 h were observed in hospital from 2015 to 2017, including 72 males and 38 females, with a ratio of 1.89： 1 between males and females. The death ages ranged from 0 to 98 years with a mean of 61.6 ± 26.0 years. The median age was 65.5 years of age, men are concentrated in the age group of over 60 years old and under 70 years of age, women are concentrated in the age group of 80 years and older under 90 years of age. The first three departments of death within 24 hours of admission were cardiology, emergency department and critical care medicine. 75.23% of death cases within 24 hours of admission were in high risk group. The CMI value of death cases within 24 hours after admission was（2.3552±1.7481）, which was lower than the death rate within 24 hours after non-admission（2.9750±2.5134）, and higher than non-death cases（0.9709±0.8936）. Conclusions Middle-aged and old men were high-risk people who died within 24 hours after hospital admission and should be the focus of prevention and treatment. Deaths within 24 hours after admission could be used as the focus of hospital quality and safety monitoring and defect management, thereby contributing to the continuous improvement of medical quality.