温州市城区老年患者院前急救流行病学调查研究

Epidemiological investigation of pre-hospital care for elderly patients in Wenzhou urban area

目的总结温州市城区老年患者院前急救的流行病学特征,为改善院前急救提供参考。方法对2013年1月至2016年1月期间的温州市城区院前急救1200例老年患者的年龄、性别、发病时间、诊断、调度时间、到达时间、现场时间等资料进行流行病学统计。结果与58例院前死亡者相比,1142例院前非死亡者现场时间更短,差异有统计学意义(t=6. 016,P<0. 05);调度时间、到达时间接近,差异无统计学意义(t=1. 135、0. 957,P>0. 05)。院前急救和院前死亡者疾病类别以循环系统、神经系统比重最大,分别为28. 4%和25. 6%、21. 8%和17. 2%。1200例院前急救多见于71～80岁(39. 7%)、81～90岁(34. 8%),女/男=1. 3; 58例院前死亡者多为70～100岁(86. 2%),女/男=1. 8。院前急诊和院前死亡人数:冬春季(3、11月)/夏秋季(12、1、3月)=1. 7,夜晚/白天=1. 1;就诊高峰时段为7-9点、13-15点、21-凌晨4点,高危死亡时段为13-16点、22-凌晨4点。结论增加繁忙时段急诊人物力储备、对循环和神经等系统开展针对性预防及保健、加强女性身心呵护有望进一步改善温州市城区老年患者院前急救状况。

Objective To understand the epidemiological characteristics in elderly patients from Wenzhou urban area as observed in the course of first aid provided to them so as to better inform future practice of pre-hospital care for elderly patients.Methods Firstly,the epidemiological information and pre-hospital care details such as age,sex,onset time,diagnosis,scheduling time,arrival time and site time of 1200 elderly patients from Wenzhou urban area who received pre-hospital care during the period from January 2013 to January 2016 were documented.Results Compared with 58 cases of pre-hospital death,the length of time used for on-the-site aid for the other 1142 cases of pre-hospitalization non-death was shorter(t=6.016,P<0.05).The scheduling time,arrival time for both groups were nearly the same and the difference was not statistically significant(t=1.135,0.957,P>0.05).Diseases in the circulatory system ad nervous system accounted for significant percentage in the number of diseases that incurred pre-hospital care and death,respectively being(28.4%and 25.6%)and(21.8%and 17.2%).Of the 1200 cases of pre-hospital care,39.7%were in the age bracket of 71~80;34.8%were in the age bracket of 81~90;the ratio of female/male patients was 1∶1.3.Of the 58 cases of pre-hospital death,86.2%were in the age bracket of 70~100 where the ratio of female/male patients was 1∶1.8.For the number of patients receiving pre-hospitalization care and the number of pre-hospital deaths,the ratio in terms of incidence time per winter and spring(March,November)/summer autumn(December,January,March)was 1∶1.7;the ratio in terms of incidence time per night/day was 1∶1.1.The peak time for treatment was(07∶00-09∶00),(13∶00-15∶00),(21∶00-04∶00)and the time of death from high-risk was(13∶00-16∶00)and(22∶00-04∶00).Conclusions Allocation of more emergency human resources for peak time,more health care and prevention measures taken for diseases in the circulatory and nervous systems,higher quality physical and mental care for female patients can work to improve the pre-hospitalization care for elderly patients from Wenzhou urban area.