2014年-2018年北京市某三甲医院住院病例死亡情况统计分析
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摘要
目的了解北京市某三甲医院住院患者死亡的主要特征、病死率的变化趋势,主要的死亡原因及其变化,为该院提高危重疾病诊疗水平、制定管理策略提供依据。方法通过全国人口死亡信息登记管理系统导出2014年-2018年某院全部住院死亡病例信息,根据国际疾病分类ICD-10进行编码,用Excel及SAS9.2对数据进行整理和分析。结果 2014年-2018年,北京市某院住院患者病死率为0.72%(2212/305476),男性患者病死率高于女性患者,差异有统计学意义(X~2=277.002,P<0.0001);死亡病例呈季节性分布,多发生在春季(26.31%)和冬季(26.81%);不同年龄组死因构成存在差异,5岁以下年龄组主要死因为畸形/变形/染色体异常,5～30岁的住院患者,血液/造血/免疫系统疾患为其主要死因,30～80岁的患者,恶性肿瘤为其主要死因,80岁以上年龄组主要死因为循环系统疾病;死因前三位分别为恶性肿瘤(36.44%)、循环系统疾病(27.89%)、呼吸系统疾病(16.59%)。结论应关注男性健康问题,在春冬两季加强心脑血管疾病的宣教及干预,重视和提升恶性肿瘤、循环系统疾病及呼吸系统疾病的防治水平,降低患者病死率。
Objective To explore the characteristic of death, the trend of mortality rate, and the leading causes of death and its change among the inpatients. To provide references for the hospital in critical disease identification,improvement of diagnosis and treatment, and management strategy formulation. Methods The data of death cases among residents from 2014 to 2018 was collected by the National Death Cause Reporting System, and classified according to the death causes code "International Classification of Diseases 10 th edition". Excel and SAS 9.2 were used for data collation and analysis. Results From 2014 to 2018, the mortality rate of the resident was0.72%(2212/305476), and the mortality rate of male was significantly higher than the female(X~2=277.002, P<0.0001). The death usually occurs in spring(26.31%)and winter(26.81%); The cause of death was different between age groups, the main death causes among under 5 years group, 5～30 years group, 30～80 years group and over the age of 80 was deformity/distortion and chromosome abnormalities(<5 years old), blood/hematopoietic/immune system diseases(5～30 years old), tumour(30～80 years old) and circulatory system diseases(>80 years old)respectively. The three leading causes of death were cancer(36.44%), circulatory system disease(27.89%) and respiratory disease(16.59%). Conclusion The health problems of male should be recognized, some interventions and precautions should be taken to prevent cardiovascular and cerebrovascular diseases in spring and winter. The implementation of strategies and interventions to cancer,circulation system diseases and respiratory diseases is urgently required to reduce the mortality rate and to improve healthy level of the crowd.
Objective To explore the characteristic of death, the trend of mortality rate, and the leading causes of death and its change among the inpatients. To provide references for the hospital in critical disease identification,improvement of diagnosis and treatment, and management strategy formulation. Methods The data of death cases among residents from 2014 to 2018 was collected by the National Death Cause Reporting System, and classified according to the death causes code "International Classification of Diseases 10 th edition". Excel and SAS 9.2 were used for data collation and analysis. Results From 2014 to 2018, the mortality rate of the resident was0.72%(2212/305476), and the mortality rate of male was significantly higher than the female(X~2=277.002, P<0.0001). The death usually occurs in spring(26.31%)and winter(26.81%); The cause of death was different between age groups, the main death causes among under 5 years group, 5～30 years group, 30～80 years group and over the age of 80 was deformity/distortion and chromosome abnormalities(<5 years old), blood/hematopoietic/immune system diseases(5～30 years old), tumour(30～80 years old) and circulatory system diseases(>80 years old)respectively. The three leading causes of death were cancer(36.44%), circulatory system disease(27.89%) and respiratory disease(16.59%). Conclusion The health problems of male should be recognized, some interventions and precautions should be taken to prevent cardiovascular and cerebrovascular diseases in spring and winter. The implementation of strategies and interventions to cancer,circulation system diseases and respiratory diseases is urgently required to reduce the mortality rate and to improve healthy level of the crowd.
引文
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[9]张天遨,邓朝晖.胆管闭锁病因学研究进展[J].中国实用儿科杂志,2017(10):794-797.
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[11]陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2018,27(1):1-14.
[12]张晓怡,沈毅,韩雅斌,等.桐乡市常见恶性肿瘤危险因素分析[J].预防医学,2014(2):150-153.
[2]徐少博,徐威威.2008年-2013年住院患者死亡情况统计分析[J].中国病案,2014,15(9):54-55.
[3]高铭涛,朱贇,贺莉萍,等.2010年-2014年某地级市三甲医院死亡病例死因分析[J].中国病案,2016,17(6):66-69.
[4]曾智,陈雯,石景容,等.企业工人社会心理因素对心理健康影响结构方程模型分析[J].中国职业医学,2017,44(2):188-192,197.
[5]Alan D.Lopez,张蓓蕾.死亡率的性别差异[J].国外医学(社会医学分册),1986,3(1):40-45.
[6]杨文娟,王振才.脑卒中发病率的季节特性及年龄变化趋势[J].中西医结合心脑血管病杂志,2015,13(9):1123-1125.
[7]李辉.季节变化对急性心梗发病的影响[J].中国卫生标准管理,2014,5(13):118-119.
[8]高铭涛,朱贇,贺莉萍,等.2010年-2014年某地级市三甲医院死亡病例死因分析[J].中国病案,2016,17(6):66-69.
[9]张天遨,邓朝晖.胆管闭锁病因学研究进展[J].中国实用儿科杂志,2017(10):794-797.
[10]张爽,沈成风,王德征,等.2010-2013年天津市儿童恶性肿瘤发病与死亡分析[J].中国肿瘤,2017(7):501-506.
[11]陈万青,孙可欣,郑荣寿,等.2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤,2018,27(1):1-14.
[12]张晓怡,沈毅,韩雅斌,等.桐乡市常见恶性肿瘤危险因素分析[J].预防医学,2014(2):150-153.