918例80岁以上老年人共病调查及特点分析

Surveying and characteristics of comorbiditys in senile people:report of 918 cases

目的了解高龄老年住院患者慢性病种类、慢性共病类型及其分布特点。方法回顾性选取2018年8月~2019年8月原解放军南京总医院老年病研究中心保障的918例干休高龄老年患者病历资料,采用自行设计的调查问卷,调查内容包括性别、年龄等一般人口学特征以及慢性病检出情况等,筛选出25种慢性疾病,对慢性病类型及慢性共病特点进行统计分析。结果25种慢性病中患病率最高的前5位疾病分别为高血压(75.97%)、脑血管病(61.76%)、冠心病(51.52%)、骨关节病(38.34%)及心功能不全(38.24%)。90.30%的高龄老人患有两种或两种以上的慢性疾病,平均慢性共病为(5.79±2.84)种。将慢性病两两组合成疾病对,特定疾病对的实际共同患病率较理论患病率高,高血压与脑血管病(OR=2.86,95%CI 2.12~3.92;P<0.01)、高血压病与冠心病(OR=6.67,95%CI 4.66~9.54;P<0.01)、冠心病与心功能不全(OR=27.20,95%CI 18.01~41.07;P<0.01)。结论高龄老年人群慢性病检出率较高,且慢性病共病检出率较高,多种慢性病存在相关关系。干预共病行为危险因素,可以改善高龄老年人生活水平,提高社区慢性病管理的效率。

Objective To investigate the types of chronic diseases,the types of chronic comorbidities and their distribution characteristics in senior people.Methods In this study,Clinical data of 918 senior community patients in the Research Center for Geriatrics of Nanjing General Hospital of Nanjing Military Region from August 2018 to August 2019 were collected and retrospectively analyzed.Self-designed questionnaires were adopted,and the content included general demographic data such as gender and age and the detection results of chronic diseases.Based on the presence of 25 common chronic conditions,types of these diseases and characteristics of comorbidities were investigated.Chi-square test was used for enumeration data;one-way analysis of variance or t test was used for statistical analysis in measure data.Results The top 5 diseases with the highest prevalence among 25 chronic diseases was hypertension(75.97%),cerebrovascular disease(61.76%),coronary heart disease(51.52%),and bone and joint disease(38.34%)and cardiac insufficiency(38.24%).90.30%of elderly people had two or more chronic diseases,and the mean number of comorbid condition was(5.79±2.84).Two kinds of chronic disease were combined into one disease pair,and the actual common prevalence of specific disease pairs was higher than the theoretical prevalence,such as hypertension and cerebrovascular disease(OR=2.86,95%CI 2.12-3.92;P<0.01),hypertension and coronary heart disease(OR=6.67,95%CI 4.66-9.54;P<0.01),coronary heart disease and cardiac insufficiency(OR=27.20,95%CI 18.01-41.07;P<0.01).Conclusion Prevalence of chronic disease and prevalence of comorbidities of chronic disease are both higher in senior people.There are statistically significant correlations among chronic diseases.Through further research on comorbidities and intervention in shared behavioral risk factors,it can improve the living standards,and the efficiency of chronic disease management in senior people.