2020—2022年某医院择期手术患者死亡病例分析

Analysis of death cases of elective surgery patients in a hospital from 2020 to 2022

目的了解某院择期手术患者围手术期死亡的影响因素,为医院加强围手术期管理,降低术后病死率提供数据参考。方法从某三甲综合医院病案首页管理系统检索2020年1月1日至2022年12月31日期间施行择期手术的患者信息,并从主要诊断、手术方式、手术科室和术后病死原因进行回顾性分析。结果2020—2022年该院施行择期手术患者81722例,其中术后死亡患者103人次,择期手术患者病死率0.13%;择期手术死亡患者原发疾病系统的前3位分别为循环系统疾病、肿瘤和先天性疾病,占比为85.43%;择期术后死亡患者主要手术类型依次为心脏类手术、主动脉手术和颅脑手术,占比为46.07%;术后死亡病例主要集中在心胸血管外科重症、心血管内科、血管外科、神经外科、介入科;主要死因为手术并发症,占比44.66%,其次分别为原发疾病加重和术后突发其他疾病,占比分别为32.04%和23.30%。结论相关手术科室加强围手术期患者术前、术中和术后的管理,职能部门对择期术后患者死亡较多的科室,开展专项管理,对降低择期手术患者术后病死率有重要意义。

Objective To understand the influencing factors of perioperative death of elective surgery patients in a hospital,and to provide data reference for hospitals to strengthen perioperative management and reduce postoperative mortality.Methods The information of patients who underwent elective surgery from January 1,2020 to December 31,2022 was retrieved from the medical record homepage management system of a tertiary general hospital,and the main diagnosis,surgical method,surgical department and causes of postoperative death were retrospectively analyzed.Results From 2020 to 2022,81722 patients underwent elective surgery in the hospital,of which 103 patients died after the surgery,with a mortality rate of 0.13%;the top three primary diseases were circulatory system disease,tumor minor and congenital disease,accounting for 85.43%;the main surgical types of patients who died after elective surgery cardiac surgery,aortic surgery and craniocerebral surgery,accounting for 46.07%;postoperative death cases were mainly concentrated in the departments of cardiothoracic surgery,cardiovascular surgery,cardiovascular medicine,vascular surgery,neurosurgery and intervention;the main cause of death was surgical complications,accounting for 44.66%,followed by primary disease aggravation and other diseases after the surgery,accounting for 32.04%and 23.30%respectively.Conclusion The relevant surgical departments should strengthen the management of preoperative,intraoperative and postoperative perioperative patients.The functional departments should carry out special management for the departments with more deaths of elective postoperative patients,which is of great significance to reduce the postoperative mortality of patients undergoing elective surgery.