北京某三甲医院60岁及以上患者死亡原因分析

Analysis of death causes for patients aged 60 years and over at a level A tertiary hospital in Beijing

目的了解近年来三甲医院老年患者死亡原因,死因顺位及变化情况,为有效预防和管理老年人群疾病提供建议和依据。方法收集2010年1月至2016年10月北京大学人民医院60岁以上所有死亡病例(共3991例),进行回顾性研究。结果近7年内前四位死因依次为循环系统疾病1201例(30.1%)、呼吸系统疾病1074例(26.9%)、肿瘤927例(23.2%)和消化系统疾病284例(7.1%),男性和女性死因顺位无明显差异。随年份变化,死因占比中呼吸系统疾病逐年上升,循环系统疾病及肿瘤呈下降趋势。2010—2013年首位死因是循环系统疾病,2014—2016年首位死因是呼吸系统疾病。不同年龄段首位死因不同,60~74岁患者首位死因为肿瘤,75~84岁患者为循环系统疾病,85岁以上患者为呼吸系统疾病。循环系统疾病中主要死因是冠心病,呼吸系统疾病中主要死因是肺部感染,肿瘤中主要死因是消化系统肿瘤。结论近年来我院老年人首位死因是循环系统疾病。随年份变化,呼吸系统疾病在老人死亡原因中占比升高。不同年龄段主要死亡原因不同,对各年龄段老年人疾病的筛查和预防可有侧重。

Objective To investigate the death causes in recent years, the ranking of causes and changes in ranking in elderly patients at a level A tertiary hospital in Beijing, in order to provide suggestions and a basis for effective prevention and management of diseases, achieve better utilization of medical resources and improve quality of life in the elderly. Methods Death records of 3991 patients aged over 60 years in the People's Hospital of Peking University from January 2010 to October 2016 were collected and retrospectively analyzed with SPSS 20.0 by using descriptive statistics, the linear-by-linear association test and the Pearson correlation coefficient. Results In the past 7 years, the top four causes of death were diseases of the circulatory system(1074 cases, 30.1%), the respiratory system(1074 cases, 26.9%), tumors(927 cases, 23.2%)and the digestive system(284 cases, 7.1%). There was no significant difference in the ranking of death causes between males and females.Of the death causes, the mortality rate of respiratory diseases increased and the mortality rates of the circulatory system and tumors decreased year by year.Diseases of the circulatory system ranked first in the death causes from 2010-2013, and diseases of the respiratory system ranked first from 2014-2016.The primary death cause was different in different age groups, with cancer for the 60-74 years old group, diseases of the circulatory system for the 75-84 years old group, diseases of the circulatory system for the over 85 years old group.The leading causes for death were coronary heart disease for diseases of the circulatory system, pulmonary infections for diseases of the respiratory system and digestive system tumors for tumors. Conclusions In recent years, the primary death cause in elderly patients at our hospital is circulation system diseases.The mortality rate of respiratory diseases has increased year by year.Death causes vary in different age groups, suggesting it is necessary to provide different screening and prevention measures for the elderly at different ages.