某三级医院2015~2020年住院死亡患者分析

Analysis of inpatient deaths in a tertiary hospital in 2015-2020

目的分析某三级医院2015~2020年住院死亡患者特征,为防病治病、医疗资源合理配置、医疗科研提供参考依据。方法365256例住院患者,其中,住院死亡患者有2219例,对其临床资料进行搜集、整理,分析住院死亡患者的时间分布、性别分布、年龄分布、季节分布、科室分布、根本死因,运用Excel、SPSS20.0软件进行数据统计。结果2015年11月1日~2020年11月1日的住院患者共365256例,死亡患者共2219例,死亡率为0.61%;住院死亡率以2015年最高(0.71%),2020年最低(0.55%),有随时间逐渐降低的趋势。住院患者中,男170745例,住院死亡率为0.72%,女194511例,住院死亡率为0.51%,男性的住院死亡率高于女性,差异有统计学意义(P<0.05)。≥81岁的住院死亡率最高(2.86%),21~30岁的住院死亡率最低(0.11%);≥81岁的住院死亡率明显高于其他年龄层,差异有统计学意义(P<0.05)。冬季(12~2月)的住院死亡率最高(0.65%),夏季(6~8月)的住院死亡率最低(0.55%)。肿瘤科的住院死亡率最高(2.95%),其后依次是神经外科(1.52%)、感染科(1.21%)、中心重症加强护理病房(ICU)(1.08%)、消化内科(0.95%)、内心科/神经内科(0.79%)、呼吸内科(0.42%)、普外科(0.20%)、泌尿外科/康复科/儿科(0.11%)、骨科(0.07%)、肾内科(0.06%)、内分泌内科(0.03%)、妇科(0.02%)、产科(0.002%)。住院死亡患者的根本死因中,构成比排名前5位依次是肿瘤(31.05%)、循环系统(28.08%)、呼吸系统(12.03%)、损伤与中毒(9.15%)、消化系统(8.52%)。肿瘤住院死亡患者的具体病因中,以支气管癌或肺癌(25.54%)、胃癌(10.01%)、肝癌(7.11%)最为常见。循环系统住院死亡患者的具体病因中,以动脉硬化性心脏病(31.14%)、脑梗死(21.03%)、脑出血(11.24%)最为常见。呼吸系统住院死亡患者的具体病因中,以慢性阻塞性肺疾病(慢阻肺)(43.07%)、肺炎(22.10%)、呼吸衰竭(5.24%)最为常见。结论肿瘤是某三级医院住院患者死亡的主因,应引起高度重视,积极防治,并加强对患者治疗期间的管理,以降低死亡率。

Objective To analyze the characteristics of inpatient deaths in a tertiary hospital in 2015-2020,so as to provide a reference basis for disease prevention and treatment,rational allocation of medical resources,and medical research.Methods Of 365256 inpatients,there were 2219 dead inpatients,and their clinical data was collected and sorted out,and the time distribution,gender distribution,age distribution,seasonal distribution,department distribution,and underlying cause of death of inpatient death were analyzed,and Excel and SPSS 20.0 software were used for data statistics.Results A total of 365256 inpatients from November 1,2015 to November 1,2020,and 2219 patients died,with a mortality rate of 0.61%;the inpatient mortality was highest in 2015(0.71%)and lowest in 2020(0.55%),with a trend of gradual decrease over time.Among the inpatients,there were 170745 males,with an inpatient mortality of 0.72%,and 194511 females,with an inpatient mortality rate of 0.51%;the inpatient mortality in males was higher than that in females,and the difference was statistically significant(P<0.05).Inpatient mortality was highest in those≥81 years old(2.86%)and lowest in those 21-30 years old(0.11%);the inpatient mortality in those≥81 years old was significantly higher than that in other age groups,and the differences were statistically significant(P<0.05).Inpatient mortality was highest(0.65%)in winter(December to February)and lowest(0.55%)in summer(June to August).The inpatient mortality in oncology department was the highest(2.95%),followed by neurosurgery department(1.52%),infection department(1.21%),central intensive care unit(ICU)(1.08%),digestive department(0.95%),cardiology department/neurology department(0.79%),respiratory department(0.42%),general surgery department(0.20%),urology department/rehabilitation department/pediatrics department(0.11%),orthopedics department(0.07%),nephrology department(0.06%),endocrinology department(0.03%),gynecology department(0.02%)obstetric department(0.002%).Among the underlying causes of death of inpatients,the top 5 composition ratios were tumors(31.05%),circulatory system(28.08%),respiratory system(12.03%),injury and poisoning(9.15%),and digestive system(8.52%).Among the specific causes of inpatient deaths from tumors,bronchial or lung cancer(25.54%),gastric cancer(10.01%),and liver cancer(7.11%)were the most common.Atherosclerotic heart disease(31.14%),cerebral infarction(21.03%),and cerebral hemorrhage(11.24%)were the most common causes of inpatient death in the circulatory system.Chronic obstructive pulmonary disease(43.07%),pneumonia(22.10%),and respiratory failure(5.24%)were the most common causes of inpatient death in the respiratory system.Conclusion Tumor is the main cause of death of inpatients in a tertiary hospital,which should be highly valued,actively prevented and treated,and strengthened management of patients during treatment to reduce mortality.