摘要
目的收集某省三级甲等(三甲)综合医院住院死亡病例数据,分析住院死亡病例特点、变化趋势、抢救情况及相关影响因素,为医院死亡病例管理及提高医疗质量提供参考.方法通过检索医院病案数据资料库,收集2012年1月1日至2022年12月31日某三甲综合医院住院死亡病例的性别、年龄、住院科室、住院时间、死亡病因、抢救措施、序贯器官衰竭评分(SOFA)等相关资料,汇总统计该院死亡病例的特点;采用Spearman秩相关系数分析两研究变量的相关性;采用多因素Logistic回归分析探讨影响住院患者死亡事件发生时抢救措施实施的相关因素,并绘制受试者工作特征曲线(ROC曲线),分析影响住院患者死亡事件发生时心肺复苏实施的相关因素.结果①该院10年中住院患者院内病死率0.26%,院内男性患者的病死率明显高于女性[0.32%(1959/607170)比0.19%(1021/549802),χ^(2)=210.615,P<0.01],住院患者的病死率随年龄增长而升高(r=0.860,P=0.037),>65岁老年患者是住院死亡的主要群体;②构成该院患者死亡的前5位主要原因为肿瘤、循环系统疾病、呼吸系统疾病、消化系统疾病及症状、体征和临床与实验室异常所见,因该5类疾病死亡的患者占死亡总患者数的82.05%(2445/2980);③该院住院患者在死亡事件发生前心电监护率为77.99%,肾上腺素使用率为83.46%,气管插管率为57.55%,心肺复苏实施率为44.93%,电除颤率为12.85%.男性死亡患者的肾上腺素使用率[86.17%(1688/1959)比78.26%(799/1021)]、气管插管率[59.37%(1163/1959)比54.06%(552/1021)]、心肺复苏实施率[46.30%(907/1959)比42.31%(432/1021)]均明显高于女性(均P<0.05);年龄>65岁死亡患者的心肺复苏实施率明显低于其他年龄段[43.25%(734/1697)比47.16%(605/1283),P<0.05];外科住院患者死亡事件发生前心电监护率[68.63%(641/934)比82.26%(1679/2041)]、肾上腺素使用率[75.48%(705/934)比87.21%(1780/2041)]及心肺复苏实施�
Objective To collect the data of hospitalized death cases in a provincial grade A tertiary general hospital,analysis the characteristics,changing trends,rescue conditions and related influencing factors of inpatient death cases,and provide a reference for the hospital's death case management and improvement of medical quality.Methods The gender,age,inpatient department,length of hospitalization,cause of death,rescue measures,sequential organ failure assessment(SOFA)score,and the date of death cases in a grade A tertiary general hospital from January 1,2012,to December 31,2022,were collected from the hospital medical record database.The characteristics of death cases were then statistically summarized through data aggregation.Spearman's rank correlation coefficient was used to analyze the relationship between the two research variables,while multivariate Logistic regression analysis was employed to explore the relevant factors affecting the implementation of rescue measures when death events occur in hospitalized patients,and draw the receiver operator characteristic curve(ROC curve)to analyze the relevant factors affecting the implementation of cardiopulmonary resuscitation in the event of death in hospitalized patients.Results The in-hospital mortality rate of inpatients in this hospital in the past 10 years was 0.26%,the mortality rate of males was significantly higher than that of females[0.32%(1959/607170)vs.0.19%(1021/549802),χ^(2)=210.615,P<0.01],the mortality rate of hospitalized patients increased with age(r=0.860,P=0.037),and elderly patients>65 years old were the main group of hospital deaths;②The top 5 main causes of death among patients in this hospital were tumors,circulatory system diseases,respiratory system diseases,digestive system diseases and the symptoms,signs,clinical and laboratory abnormal findings,and those who died due to these 5 types of diseases accounted for 82.05%(2445/2980)of the total number of deaths;Before the death event,the electrocardiogram(ECG)monitoring rate of inpatients
作者
肖雯
蒋宇
程婷
祝益民
陈芳
Xiao Wen;Jiang Yu;Cheng Ting;Zhu Yimin;Chen Fang(Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics,the First Afiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Changsha 410005,Hunan,China;Hunan Provincial Institute of Emergency Medicine,Changsha 410005,Hunan,China;Hunan Provincial Resuscitation Quality Control Center,Changsha 410005,Hunan,China;College of Life Science,Hunan Normal University,Changsha 410081,Hunan,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2023年第6期713-718,共6页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家科技部项目(2018FY10060005)
中央引导地方科技发展项目(2019CT5016)。
关键词
住院患者
死亡病例
抢救措施
心肺复苏
Hospitalized patients
Death cases
Rescue measures
Cardiopulmonary resuscitation
