摘要
目的总结急诊老年与非老年患者的死亡原因分布特点,以提升老龄化城市的急危重症的救治效力。方法回顾性分析北京大学首钢医院急诊科2014年1月1日至2021年12月31日的1799例急诊科完整死亡病案,根据年龄分为老年组(≥60岁)和非老年组(<60岁),对两组患者的性别构成、死亡原因、变化趋势及季节分布等数据进行统计分析。结果急诊死亡病例中老年组大于非老年组(P<0.01);老年组男性占比小于女性(0.97∶1),非老年组男性占比大于女性(3.29∶1),差异有统计学意义(P<0.01)。帕累托图分析显示,老年组主要死因顺位为呼吸系统疾病、晚期肿瘤、猝死,非老年组主要死因顺位为猝死、晚期肿瘤、呼吸系统疾病。呼吸系统疾病老年组大于非老年组,猝死老年组小于非老年组,差异均有统计学意义(P<0.01),晚期肿瘤死亡率老年组小于非老年组,但差异无统计学意义(P>0.05)。将前后4年主要死因进行比较,老年组呼吸系统疾病、晚期肿瘤呈上升趋势,非老年组猝死呈下降趋势,且差异均具有统计学意义(P<0.05)。在季节分布中,老年组冬季死亡人数最多,夏季死亡人数最少,四季分布差异有统计学意义(P<0.01),非老年组季节分布特点与老年组的四季分布特点不同,春季死亡人数最多,且差异无统计学意义(P>0.05)。进一步分析老年组主要死亡原因的季节分布特点,冬季呼吸系统疾病死亡人数最多(P<0.05)。结论随着人口老龄化进程明显加快,急诊医疗资源面临着重大挑战,急诊科应根据年龄差异、主要死因及季节分布特点等合理优化急诊资源配置,提高急危重症患者救治成功率,推动急诊学科建设的高质量发展。此外,晚期肿瘤占用大量急诊资源值得思考。
Objective To summarize the distribution characteristics of death causes of the elderly and nonelderly patients in the Department of Emergency,so as to improve the treatment effectiveness of acute and critical diseases in aging cities.Methods A retrospective analysis was made on 1799 complete medical cases of death patients in the Department of Emergency of Peking University Shougang Hospital from January 1,2014 to December 31,2021.According to their ages,they were divided into the elderly group(≥60 years old)and the non-elderly group(<60 years old).The data of gender composition,causes of death,changing trend and seasonal distribution of the two groups of patients were statistically analyzed.Results In the department of emergency,the number of death patients in the elderly group was higher than that in the non-elderly group(P<0.01).In the elderly group,the percentage of male patients was smaller than that of female patients(0.97∶1).And in the non-elderly group,the percentage of male patients was larger than that of female patients(3.29∶1),with statistically significant differences(P<0.01).It was showed by Pareto chart analysis that the cis position of main causes of death in the elderly group was respiratory diseases,advanced tumors and sudden death,while that in the non-elderly group was sudden death,advanced tumors and respiratory diseases.The percentage of respiratory diseases in the elderly group was larger than that in the non-elderly group,and the percentage of sudden death in the elderly group was smaller than that in the non-elderly group,with statistically significant differences(P<0.01).The mortality of advanced tumor in the elderly group was smaller than that in the non-elderly group,without statistically significant difference(P>0.05).By comparing the main causes of death in the previous four years and the current four years,the respiratory diseases and advanced tumors in the elderly group showed an upward trend,while the sudden death in the non-elderly group showed a downward trend,both with st
作者
赵晓丽
刘冰
范宝军
马莹暄
格日勒图
祝振忠
ZHAO Xiaoli;LIU Bing;FAN Baojun;MA Yingxuan;Geriletu;ZHU Zhenzhong(Department of Emergency,Peking University Shougang Hospital,Beijing 100144,China;Department of Medical Records,Peking University Shougang Hospital,Beijing 100144,China)
出处
《中国医药科学》
2023年第6期172-176,共5页
China Medicine And Pharmacy
基金
北京市石景山区医学重点扶持专科建设项目(石卫健医发﹝2020﹞21号)。
关键词
急诊
死亡
老年人
帕累托图
Emergency treatment
Death
The elderly
Pareto chart
