某院2009—2019年住院患者死因统计分析

Death causes analysis among inpatients from a hospital between 2009 and 2019

目的分析近11年某院住院死亡病例情况,为合理配置医疗资源提供决策依据。方法按ICD-10疾病分类,采用描述性流行病学方法,对某院2009—2019年住院死亡病例进行分析。结果某院住院患者病死率为1.12%,呈现逐年降低趋势(χ2=237,P<0.001)。经多因素logistic回归分析显示,65岁以上年龄组病例(OR=50.11,95%CI:30.65~81.92)、男性病例(OR=1.42,95%CI:1.34~1.51)、本省本市住院病例(OR=1.66,95%CI:1.52~1.82)、急诊入院病例(OR=3.42,95%CI:3.20~3.66)、单纯西医治疗病例(OR=6.67,95%CI:4.51~9.88)、非手术病例(OR=5.43,95%CI:4.70~6.28)死亡风险均增加。死亡病例主要死因依次为肿瘤(30.75%)、循环系统疾病(26.75%)、呼吸系统疾病(20.52%),肿瘤、循环系统疾病、呼吸系统疾病死因中比例最高的分别为消化器官恶性肿瘤、缺血性心脏病、呼吸系统的其他疾病。结论采取有效措施防治恶性肿瘤、循环系统疾病及呼吸系统疾病有助于降低社会人群的病死率;应加强对老年人群、男性人群的健康关注;应注意提升内科疾病的治疗水平,同时注意对住院患者适时开展中西医结合治疗。

Objective To explore the causes of death in hospitalized patients during the 11 years and provide basis for rational allocation of medical resources.Methods According to ICD-10 disease classification,a descriptive epidemiological study was performed on the causes of death in hospitalized patients between 2009 and 2019.Results Between 2009 and 2019,the case fatality rate(CFR)decreased yearly(χ2=237,P<0.001)and the average CFR was 1.12%.The analysis of multiple logistic regression showed that,the highest CFR occurred in the group aged 65 and above(OR=50.11,95%CI:30.65-81.92),male(OR=1.42,95%CI:1.34-1.51),the region in native(OR=1.66,95%CI:1.52-1.82),the emergency admission(OR=3.42,95%CI:3.20-3.66),only western medicine treatment(OR=6.67,95%CI:4.51-9.88),nonoperative patient(OR=5.43,95%CI:4.70-6.28).The top 3 causes of death were tumor(30.75%),circulatory disease(26.75%),and respiratory disease(20.52%),respectively;among them the main causes were digestive organs malignant neoplasms,ischaemic heart diseases and other diseases of the respiratory system,respectively.Conclusion The prevention and treatment of the top 3 causes of death diseases should be strengthened;clinically targeted intervention should be strengthened for population of 65 years old and above and male,and internal medicine diseases;diagnosis and treatment should be combined with traditional Chinese and western medicine.