低风险病种死亡原因的影响因素分析

Analysis of Influencing Factors on Death Causes of Low-risk Diseases

目的 分析低风险病种患者住院死亡相关影响因素,为加强医院对低风险病种住院患者死亡管理提供参考依据。方法 收集某三甲医院2018年1月1日-2020年12月31日低风险病种患者住院死亡病例20例作为病例组,以病种匹配,按照完全随机抽样的方法抽取低风险病种患者住院非死亡病例80例作为对照组,收集两组患者的年龄、住院天数、住院次数、高血压史、手术、感染等病史资料,采用匹配病例对照研究、单因素分析、多因素logistic回归分析等方法对其进行统计分析,探讨影响低风险病种患者住院死亡的影响因素。结果 2018年-2020年某三甲医院20例低风险病种住院死亡患者平均年龄为67.15岁,疾病构成以消化系统疾病和内分泌、营养和代谢疾病为主,占总死亡患者的75%,共纳入胃溃疡、肠的其他疾病、胆石症、非胰岛素依赖性糖尿病、动脉粥样硬化、其他医疗照顾、紫癜和其他出血性情况7个低风险病种;单因素分析结果显示年龄、住院次数、高血压史、手术和感染差别有统计学意义(P<0.05);多因素Logistic回归分析显示年龄(OR:1.05,95%CI:1.01~1.09)、手术(OR:6.34,95%CI:1.18~34.11)和感染(OR:11.30,95%CI:2.85~44.91),均是低风险病种住院患者死亡的独立影响因素。结论 年龄、手术、感染发生是影响低风险病种住院患者死亡的重要因素,医院应加强老年病防治,加强围手术期管理和防控医院感染等措施降低低风险病种患者住院死亡。

Objective Analyze related factors influencing the death of hospitalized patients with low-risk diseases,and provide a reference for hospitals to strengthen hospital death management of inpatients with low-risk diseases.Methods Collected death cases of low-risk disease from January 1,2018 to December 31,2020 in a third-class hospital,a total of 20 cases were taken as the case group,match it to the disease,a total of 80 non-fatal inpatients with low-risk diseases were randomly selected as control group,The data of age,days of hospitalization,times of hospitalization,history of hypertension,operation and infection were collected,The data were analyzed by matching Case-control study,single factor analysis and multiple logistic regression analysis,to explore the influencing factors of in-hospital death of patients with low-risk diseases.Results 20 inpatients with low-risk diseases who died was 67.15 years from January 1,2018 to December 31,2020 in a third-class hospital,the disease composition is dominated by gastrointestinal disease and endocrine,nutritional and metabolic diseases,accounting for 75% of total deaths,a total of 7 low-risk diseases including gastric ulcer,other diseases of intestinal,cholelithiasis,non-insulin-dependent diabetes mellitus,arteriosclerosis,other medical care,purpura and other haemorrhagic conditions;Univariate analysis showed that there were significant differences(P<0.05) in age,number of hospitalizations,surgery and infection;Multivariate logistic regression analysis showed that age(OR:1.05,95% CI:1.01~1.09),surgery(OR:6.34,95% CI:1.18~34.11)and infection(OR:11.30,95%CI:2.85~44.91),are all independent influencing factors of death of hospitalized patients with low-risk diseases.Conclusions The age,surgery and infection occurrence are important factors for the death of hospitalized patients with low-risk diseases,the hospital strengthen the prevention and treatment of geriatric diseases,strengthening perioperative management and prevention and control of hospital infection to reduce the death of patients with low-risk diseases.