西部贫困地区人群猝死流行病学资料调查分析及对策探讨

Investigation and analysis of epidemiological data of sudden death in poor areas of western China and countermeasures

目的对西部贫困地区-陕西南部汉中行政区域3年发病的猝死病种进行流行病学资料回顾调查分析,为贫困区域健康脱贫工作中开展人群猝死防治救提供大数据支撑及参考,并对相应防治救策略进行初步探讨.方法通过对"中国疾病预防控制系统2.0"中的死因监测平台网络直报系统资料及区域内一、二、三级共33个医院填报资料进行筛查.查漏补缺,对信息不全资料进行补充.将收集到的2016年3月—2019年3月间陕西南部汉中行政区域人群猝死死亡资料进行系统统计分析,研究其在分布、职业、病种、猝死发生地及年龄性别构成比等方面的流行病学指标特点.结果汉中市2016年3月—2019年3月死因监测人口为1142.04万人,死亡67380人,死亡率约为590/10万.其中猝死4645人,占全死因人数的6.89%;84.58%发生在院外.男性2698例,死亡占比为58.1%,女性1947例,死亡占比为41.9%.猝死年龄在31~50岁开始明显攀升(占近50%);职业以农民明显居多(60.89%).结论西部汉中地区人群猝死在发生地及年龄、性别、职业等分布方面存在明显差异(P<0.01);猝死向低年龄组及院外发生趋势明显.应对策略应体现在理念转变及防治救体系的综合建设等多个方面.

Objective To survey the epidemiological characteristics of sudden death in the western poverty-stricken areas in China,Hanzhong Administrative Region in Southern Shaanxi.Methods The data of sudden death in Hanzhong,one of the western poverty-stricken areas in China,March 2016~March 2019,were collected from the Network Direct Report System of Cause of Death Monitoring Platform,China Disease Prevention and Control System 2.0.A questionnaire,on relevant data was issued to thirty three hospitals grade I to grade 3 in whole for verification and supplement.The population data were supplied by the Hanzhong Public Security Bureau.SPSS 12.0 software was used to analyze the data.Results 11.4204 million people underwent the survey.67380 people died with a death rate of 590/100000,including 4645 cases of sudden death accounting for 6.89%of the entire causes of death.Among the 4645 cases,2698 were males,accounting for 58.1%,a percentage significantly higher than that of the 1947 females(41.9%,P<0.01).The death toll began to climb since the age period 31〜50(nearly 50%),peaked in the age period 61〜71,and began to drop since the age of 71.Most of the sufferers of sudden death(60.89%)were peasants.3929 case occurred outside the hospital(84.58%).Conclusion The occurrence rate of sudden is high in the Hanzhong area,especially high in the males in comparison with the females,and among the peasants compared with other occupations.