某老年病院ICU住院患者疾病特征及预后分析

Analysis of disease characteristics and prognosis of ICU inpatients in a geriatric hospital

目的了解我院近2年综合重症加强护理病房(ICU)患者的住院相关情况,为我院各专业科室建设提供参考。方法收集我院2016年6月至2018年6月期间收治的200例ICU患者,均保留完整的住院病历记录,统计ICU患者的疾病构成类型、疾病类型的年龄分布、ICU患者病情转归以及院内感染情况。结果本组ICU患者病型以恶性肿瘤26. 50%、脑血管意外22. 50%、外伤21. 00%为主,其次为急腹症、肺炎、心血管疾病等,疾病谱构成差别有统计学意义(P <0. 01); ICU患者1～18岁以外伤为主,19～40岁、41～65岁以恶性肿瘤、外伤为主,66～82岁以恶性肿瘤、脑血管意外为主,不同年龄段疾病谱构成差别有统计学意义(P <0. 01); ICU患者治疗后转科占73. 50%,高于死亡者占比的20. 00%、出院占比的6. 50%,病情转归结局构成比差别有统计学意义(P <0. 01); ICU转科率最高的是恶性肿瘤31. 97%、脑血管意外23. 81%,死亡率最高的是外伤40. 00%,ICU转科和死亡的疾病谱构成差别有统计学意义(P <0. 01); ICU院内感染率为16. 50%,且随ICU住院时间延长,院内感染率逐渐升高。结论 ICU患者疾病谱构成、不同年龄段疾病谱构成、不同疾病的病情转归以及院内感染率存在显著特征,体现出疾病谱复杂多样、跨多临床学科疾病等特点,且病情危重,易出现死亡、院内感染等情况,临床可结合统计信息针对性加强相关学科建设和医疗资源整合,努力完善ICU的医疗救治服务。

Objective To understand the hospitalization status of patients in Intensive Care Unit(ICU)in our hospital in recent 2 years,and to provide reference information for the construction of various departments in our hospital.Methods Totally 200 ICU patients admitted from June 2016 to June 2018 in our hospital were collected.All of them kept complete medical records.The disease types,age distribution,prognosis and nosocomial infection of ICU patients were analyzed.Results Malignant tumors,cerebrovascular accidents and trauma accounted for 26.50%,22.50%and 21.00%respectively,followed by acute abdomen,pneumonia,and cardiovascular diseases,etc.The ratio of disease spectrum was significantly different(P<0.01).Trauma was predominant for ICU patients aged 1 to 18 years old,malignant tumors and trauma were predominant for patients aged 19 to 40 years old and 41 to 65 years old,and malignant tumors and cerebrovascular accident were predominant for patients aged 66 to 82 years old.The disease spectrum composition of different age groups was significantly different(P<0.01).After treatment,73.50%of patients in ICU were transferred to other departments,and the ratio was significantly higher than death 20.00%and discharge 6.50%.There was a significant difference in the composition of prognosis and outcome(P<0.01).The highest conversion rate of ICU was 31.97%of malignant tumor,23.81%of cerebrovascular accident.The highest mortality rate was 40.00%of the patients with trauma.There was a significant difference in the ratio of disease spectrum between ICU transfer and death(P<0.01).The nosocomial infection rate in ICU was 16.50%,and the nosocomial infection rate increased gradually with the extension of ICU stay.Conclusions The disease spectrum composition of ICU patients,the disease spectrum composition of different age groups,the prognosis of different diseases and nosocomial infection rate have significant characteristics,reflecting the characteristics of complex disease spectrum and multi-disciplinary diseases.And these patients were in critical condition,and were easy to death and nosocomial infection and so on.Combined with statistical information,the construction of related disciplines and the integration of medical resources should be strengthened accordingly to improve ICU medical treatment services.