ICU老年意外伤害患者377例住院特征回顾性分析

A retrospective analysis on hospitalization characteristics of 377 elderly patients with accidental injury in ICU

目的分析老年意外伤害危重出院患者人口学、社会学、伤害住院特征,提出可提高老年患者疾病认知程度及意外伤害防范意识,降低其ICU住院率及重返率的对策建议。方法回顾某三级甲等综合医院重症医学科、急诊重症监护室2015年1月1日至2018年12月31日期间的老年意外伤害危重症患者病例资料,采用Excel和SPSS18.0对患者一般资料、疾病类型、ICD-10疾病编码、损伤、中毒及外部原因、伤害人数、住院费用进行统计分析。结果老年意外伤害患者377例,男女比例为1.67∶1,年龄(68.90±6.79)岁,60~69岁为伤害高发年龄段;意外伤害类型排名前五位为颅内损伤、多发伤、骨折、中毒、创伤性失血性休克;ICD-10疾病编码前5类为T79-T87(伤害并发症、医疗意外及并发症)、T00-T07(多部位损伤)、T36-T65(各类中毒、药物反应)、S00-S09(头部损伤)、S30-S39(腹部、会阴、背部及臀部损伤);损伤、中毒及外部原因包含19类,车祸伤、摔伤、高处坠落伤、中毒、蜂蛰伤、重物砸伤为主要伤害原因;6~10月为意外伤害患者住院高峰;意外伤害患者平均住院费用为47754.73元,平均住院天数为11.00d,住院费用与住院天数、年龄、伤害部位、伤害原因有一定相关性。结论老年意外伤害患者病情变化快、危重风险高、疾病负担重,基于ICU内老年意外伤害患者一般资料、住院特征的研究对该疾病的管理与防治具有一定参考价值。

Objective To analyze the characteristics of demography,sociology and injury hospitalization of elderly patients discharged from hospital with serious accidental injury and further raise measures and suggestions that can improve the disease awareness,awareness of accidental injury prevention of elderly patients and reduce the ICU hospitalization rate and return rate.Methods The case data of elderly patients with accidental injury and critical illness from January 1,2015 to December 31,2018,was analyzed via SPSS 18.0 software.Case data included general information,disease type,ICD-10 disease code,injuries,poisoning and external causes,number of injuries and hospital expenses.Results A total of 377 elderly patients with severe injuries was collected.The ratio of male to female was 1.67∶1.Age was(68.90±6.79)years old,in which 60~69 years old patients was the peak age of injury.The top five accidental injury types were intracranial injury,multiple injury,fracture,poisoning and traumatic hemorrhagic shock.The top five categories of diseases in ICD-10 were T79-T87(injury complications,medical accidents and complications),T00-T07(multi-site injuries),T36-T65(various poisoning and drug reactions),S00-S09(head injuries),and S30-S39(abdominal,perineal,back and hip injuries).Injury,poisoning and external causes included 19 categories,car accident injury,fall injury,poisoning,bee sting injury and heavy weight injury were the main causes of injury.From June to October,there was a peak of hospitalization for patients with accidental injuries.The average hospitalization cost of patients with accidental injuries was￥47754.73,and the average length of stay was 11.00 days,the cost of hospitalization was related to the length of stay,age,injury location and injury cause.Conclusion The elderly accidental injury patients presents rapid changes,high risk of critical illness,and heavy burden of disease.The general information of elderly accidental injury patients in ICU and the characteristics of hospitalization has certain value of reference for the management and prevention of this disease.