2018-2022年广州某三甲医院住院老年患者死因分析

Death cause of elderly inpatients in a tertiary hospital in Guangzhou from 2018 to 2022

目的多维度分析2018—2022年60岁及以上住院老年患者的死亡情况,了解其死因构成,为合理配置医疗资源提供依据。方法提取广州某三甲医院2018—2022年在广东省死亡医学证明管理信息系统登记的60岁及以上住院死亡患者共1716例,采用Mann-Whitney U检验、χ^(2)检验对年龄、性别、根本死亡原因等数据的分布特征进行统计分析。结果2018—2022年,住院老年死亡人数呈逐年下降趋势,男女性别比为1.67∶1。在各年龄段中男性病死率均高于女性,但差异无统计学意义(χ^(2)=0.26,P=0.992)。死亡年龄中位数为78.0(69.0,84.0)岁,女性高于男性,差异有统计学意义(Z=342.01,P=0.003)。季节分布中,冬季死亡人数最多,其次为春、秋、夏季,但差异无统计学意义(χ^(2)=5.66,P=0.773)。2018—2022年该院老年住院患者死因顺位前3位是循环系统疾病、肿瘤和呼吸系统疾病,占死亡总人数的76.34%,是导致其死亡的主要疾病类型。肿瘤导致的死亡占比呈逐年下降趋势,传染病和寄生虫病导致的死亡占比则逐年上升。研究期内,按性别、季节、年龄段分类的主要死因分布差异均具有统计学意义(P<0.05)。结论医院应合理配置医疗资源,加强循环系统疾病、肿瘤、呼吸系统疾病、传染病和寄生虫病救治和防控监测工作,尤其重视老年男性和冬季的治疗与护理,降低病死率。

Objective To analyze the deaths of hospitalized elderly inpatients aged 60 years old and above from 2018 to 2022 in a multi-dimensional manner,and to understand the composition of their causes of deaths,in order to provide a basis for rational allocation of healthcare resources.Methods Data of 1716 hospitalized dead patients aged 60 and above registered in the Guangdong Provincial Death Medical Certificate Management Information System of the hospital from 2018 to 2022 were extracted,Mann-Whitney U and chi-square tests were used to statistically analyze the distributional characteristics of variables such as age,gender,and underlying causes of death.Results From 2018 to 2022,the number of geriatric inpatient deaths showed a downward trend year by year,with a male-to-female sex ratio of 1.67∶1.In all age groups males had a higher rate of death than females,but the difference was not statistically significant(χ^(2)=0.26,P=0.992).The median age at death was 78.0(69.0,84.0)years old,which was higher in females than in males,and the difference was statistically significant(Z=342.01,P=0.003).In the seasonal distribution,the highest number of deaths occurred in winter,followed by spring,fall,and summer,and the difference was not statistically significant(χ^(2)=5.66,P=0.773).The top 3 leading causes of death of elderly inpatients in the hospital from 2018 to 2022 were circulatory diseases,tumors and respiratory diseases,accounting for 76.34%of the total number of deaths,which were the main types of diseases leading to their deaths,with a decreasing trend in the proportion of deaths caused by tumors and a yearly increase in the proportion of deaths caused by infectious and parasitic diseases.During the study period,the differences in the distribution of the main causes of death by gender,season and age group were all statistically significant(P<0.05).Conclusion Hospitals should rationalize the allocation of medical resources,strengthen the treatment and prevention,control and monitoring of circulatory diseases,tumors,respiratory diseases,infectious and parasitic diseases,and pay particular attention to the treatment and care of elderly males and in winter,so as to reduce the death rate.