142例老年急性心肌梗死死亡病例分析

Analysis of Death Cases of 142 Elderly Patients with Acute Myocardial Infarction

目的通过分析老年急性心肌梗死(AMI)死亡病例的特点,为护理人力资源管理及人员培训提供依据。方法采用回顾性分析方法收集2008年1月1日-2022年12月31日北京某三甲医院心脏重症监护病房(CCU)死亡的老年AMI患者的病历资料,整理分析入院诊断、死亡原因、死亡季节与时点分布等资料,描述性分析。结果2008-2022年CCU共142例老年AMI患者死亡,60.6%为男性,平均年龄为(79.07±6.72)岁,随着时间推移,患者的死亡年龄有升高趋势(χ^(2)=4.072,P=0.045);死亡原因前3位分别为心源性休克(48.6%)、心脏破裂(14.8%)和室性心律失常(12.7%);87.3%的患者至少合并一种其他疾病,与80岁以下的老年人相比,高龄老年死亡患者中出现心力衰竭(P=0.015)及心律失常(χ^(2)=6.404,P=0.017)的比例较高。结论近年来老年AMI患者死亡年龄有所升高,符合医疗水平及居民健康素养提高的趋势;管理者应针对心源性休克、心脏破裂等主要死因加强护理技能及各类培训、预见性地做好电除颤准备;护理人员应做好健康教育,加强护理及生活指导,减少老年患者心力衰竭等并发症的发生。

Objectives By analyzing the characteristics of death cases of elderly patients with AMI, this paper provides a basis for nursing human resources management and personnel training. Methods Retrospective analysis was performed to collect the death records of elderly patients with AMI in the cardiac care unit(CCU) of a Grade-III hospital in Beijing from January 1, 2008 to December 31, 2022. The admission diagnosis, cause of death, death season and time distribution were analyzed. Results From 2008 to 2022, a total of 142 elderly patients with AMI died in CCU. 60.6% of them were male, and the mean age was 79.07±6.72 years old. The death age showed an increasing trend with the increase of years(χ^(2)=4.072, P=0.045). The leading causes of death were cardiogenic shock(48.6%), heart rupture(14.8%), and ventricular arrhythmia(12.7%). 87.3% of dead patients had at least one other disease. Compared with the elderly under 80 years old, the elderly deceased patients had a higher proportion of heart failure(P=0.015) and arrhythmia(χ^(2)=6.404, P=0.017). Conclusions In recent years, the death age of elderly patients with AMI has increased, which accords with the trend of improving medical level and health literacy of residents. Managers should strengthen nursing skills and various kinds of training for the main causes of death such as cardiogenic shock and heart rupture and prepare for electrical defibrillation prophetically.Nursing staff should provide good health education, strengthen nursing care and life guidance, and reduce the occurrence of complications such as heart failure in elderly patients.