2017年-2020年某三甲医院住院死亡病例情况分析

Analysis of Inpatient Death Cases in a Three A and Tertiary Hospital from 2017 to 2020

目的对某三甲综合医院连续4年住院死亡病例进行分析,为提升医疗质量管理提供参考依据。方法收集某院2017年1月1日-2020年12月31日出院病例,对其中死亡病例信息进行分析,对各年病死率、死亡病例的月份分布、呼吸机使用率、住重症监护室率和死因构成及顺位等情况进行分析。结果出院人次252934例,其中死亡人数1717,病死率为0.68%,2020年病死率0.92%,明显高于前3年,差异有统计学意义。2017年-2020年住院死亡患者中住监护室比例63.89%,住院死亡患者有创呼吸机使用率为52.48%,前5位死因分别为循环系统疾病(I00-I99)、呼吸系统疾病(J00-J99)、肿瘤(C00-D48)、影响健康状况和接触服务健康的因素(Z00-Z99)、消化系统疾病(K00-K93)。结论新冠疫情期间某院住院患者病死率明显升高,但医院对死亡患者的救治质量未下降,坚持疫情防控与医疗服务并重,有效保障了医疗质量和医疗安全。执行政府指令并履行社会责任是中国特色现代公立医院的核心所在。

Objectives In order to provide reference for the improvement of medical quality management,the death cases in a Three A and Tertiary Hospital for four consecutive years were analyzed.Methods A total of 252934 cases were hospitalized in a Three A and Tertiary ospital from January 1st,2017 to December 31st,2020,among which 1717 cases died.The fatality rate,the monthly distribution of death cases,the utilization rate of ventilator,the rate of hospitalization in ICU,and the cause of death and its sequence were analyzed.Results A total of 252934 patients were discharged from hospital,among which 1717 died.The case fatality rate was 0.68%.The case fatality rate in 2020 was 0.92%,which was significantly higher than that in the previous 3 years,and the difference was statistically significant.From 2017 to 2020,63.89%of the inpatients died in intensive care units,and 52.48%of the inpatients died in invasive ventilator.The top 5 causes of death were circulatory diseases(I00-I99),respiratory diseases(J00-J99),tumors(C00-D48),factors affecting health status and health exposure to services(Z00-Z99),and digestive diseases(K00-K93).Conclusions During the period of COVID-19,the fatality rate of inpatients in a hospital increased significantly,but the quality of treatment for the dead patients did not decrease.The equal emphasis on epidemic prevention and control and medical services effectively ensured the quality and safety of medical care.Implementing government instructions and fulfilling social responsibilities was the core of modern public hospitals with Chinese characteristics.