2014—2019年某三甲医院3598例住院死亡病例统计分析

Analysis of the death situation among inpatients in a tertiary hospital in Shanghai from 2014 to 2019

目的分析上海市某三甲医院6年间住院死亡死因构成特点,为医疗资源合理配置提供参考。方法收集上海市某三甲医院2014年1月1日至2019年12月31日3598例住院死亡病例基本信息,根据ICD-10分类标准,采用SAS 9.2软件进行整理和分析。结果2014—2019年某医院住院病死率为0.67%,男性患者病死率高于女性(χ2=143,P<0.001);女性病死年龄中位数[M(IQR)]82(14)岁高于男性病死年龄中位数[M(IQR)]77(20)岁,差异有统计学意义(Z=10.08,P<0.001)。病死率随着年龄的增加而不断升高,Cochran-Armitage趋势检验差异具有统计学意义(Z=2.95,P=0.003)。不同年龄死因构成不同,20岁以下病死5例,包括2例呼吸系统疾病、1例循环系统疾病、1例起源于围生期的某些情况、1例症状/体征/临床异常。20~69岁以恶性肿瘤、循环系统疾病为最主要死因,70岁以上以循环系统疾病、恶性肿瘤、呼吸系统疾病为最主要死因;死因前3位分别为循环系统疾病(40.05%)、恶性肿瘤(31.88%)和呼吸系统疾病(11.92%)。结论循环系统疾病、恶性肿瘤和呼吸系统疾病是最主要的死亡原因,应重视提高医疗技术水平和多学科综合协作救治能力,同时重视疾病的早期筛查和干预,进而降低病死率。

Objective To analyze the characteristics of the causes of death in a tertiary hospital in Shanghai during six years,and to provide reference for the rational allocation of medical resources.Methods The basic information of 3598 inpatient deaths from January 1,2014 to December 31,2019 was collected and analyzed with SAS 9.2 software according to ICD-10 classification standard.Results The case fatality rate of hospitalized patients was 0.67%from 2014 to 2019,and the fatality rate of male patients was higher than that of female patients(χ2=143,P<0.001).The mortality age of female[M(IQR)]82(14)years old was higher than that of male[M(IQR)]77(20)years old,and the difference was statistically significant(Z=10.08,P<0.001).The mortality increased with age,and there was significant difference in Cochran Armitage trend test(Z=2.95,P=0.003).The causes of death were different between age groups,there were 5 deaths under 20 years old,including 2 cases of respiratory system disease,1 case of circulatory system disease,1 case of perinatal conditions disease,and 1 case of symptoms/signs/clinical abnormalities.Malignant tumor and circulatory system disease were the main causes of death from 20 to 69 years old.Circulatory system disease,malignant tumor and respiratory diseases were the main causes of death over 70 years old.The three leading causes of death were circulatory diseases(40.05%),malignant tumors(31.88%)and respiratory diseases(11.92%).Conclusion Circulatory system disease,malignant tumor and respiratory system disease were the main causes of death.We should pay attention to improving the level of medical technology and multidisciplinary comprehensive treatment ability,and pay attention to the early screening and intervention of diseases,so as to reduce the mortality.