河南省某综合医院2014—2021年住院死亡病例流行病特征分析

Epidemiological Characteristics of Hospitalized Death Cases in a General Hospital in Henan Province from 2014 to 2021

目的对河南省某三级甲等综合医院2014―2021年住院死亡病案进行分析,旨在了解死因分布及死因变迁规律,以期为河南省死因流行病学研究提供参考。方法通过病案首页简单综合查询系统检索离院方式为死亡的病案,利用WPS Office 2022和SPSS 21.0软件对数据进行整理和统计分析。结果共检索到5845例死亡患者,其中男3668例,女2177例,男女性别比1.68∶1。男、女性死亡患者最小年龄均为1 d,最大年龄分别为108岁和104岁,男、女性患者的年龄构成差异有统计学意义(P=0.026)。2014年、2016年、2017年第四季度为当年季度峰值,2015年、2018年、2019年第一季度为当年季度峰值,而2020年第三季度及2021年第二季度为当年季度峰值。2014―2021年所有死亡病例中,不同年份不同年龄段死亡患者的构成比差异有统计学意义(P<0.001);所有住院死亡患者死因分布前5位依次为循环系统疾病、呼吸系统疾病、肿瘤、症状体征和临床与实验室异常所见不可归类在他处者、损伤中毒和外因的某些其他后果;不同性别死因分布差异有统计学意义(P<0.001);<1岁组与P00-P96及Q00-Q99距离较近,对应的ICD-10编码分别为起源于围生期的某些情况及先天性畸形、变形和染色体异常;年份的类别均在原点附近。结论住院患者死因谱因性别、年龄段而异。应有针对性地加强慢性非传染性疾病、传染病、损伤中毒、先天性畸形、变形和染色体异常等的健康宣教,降低可控的死亡风险。

Objective To analyze the characteristics of hospitalized death cases admitted to a tertiary first-class general hospital in Henan province from 2014 to 2021,in order to understand the distribution of diseases and the change of causes of death cases,so as to provide reference for the epidemiological analysis of death causes in Henan province.Methods The simple comprehensive query system on the front page of the medical record was used to retrieve the inpatient medical records with the way of leaving the hospital as death,and the WPS Office 2022 and SPSS 21.0 software were used to sort out and statistically analyze the data.Results A total of 5845 dead patients were retrieved,including 3668 males and 2177 females,with a gender ratio of 1.68∶1.The minimum age of male and female death patients was 1 day,and the maximum age was 108 and 104 years old,respectively.There was statistically significant difference in the age composition of male and female patients(P=0.026).The fourth quarter of 2014,2016 and 2017 were the peak of the current year,the first quarter of 2015,2018 and 2019 were the peak,and the third quarter of 2020 and the second quarter of 2021 were the peak.Among all death cases from 2014 to 2021,there was statistically significant difference in the constituent ratio of death patients at different ages in different years(P<0.001).The top five causes of death in all hospitalized patients were diseases of circulatory system,diseases of respiratory system,neoplasms,symptoms,signs and abnormal clinical and laboratory findings,not elsewhere classified,injury,poisoning and certain other consequences of external causes in turn.There was statistically significant difference in the distribution of death causes between different genders(P<0.001).The<1 year old group was close to P00-P96 and Q00-Q99,and the corresponding ICD-10 codes were certain conditions originating in the perinatal period and congenital malformations,deformations and chromosomal abnormalities.The categories of years were all near the origin.Conclusion The death genealogy of inpatients varies with gender and age.Health education on chronic non-infectious diseases,infectious diseases,injury and poisoning,congenital malformations,deformation and chromosomal abnormalities should be targeted to reduce the controllable risk of death.