某医院2005~2014年老年住院患者死亡原因分析

Cause of death in elderly inpatients:an analysis for our hospital during 2005 and 2014

摘要:

目的 分析近10年老年住院患者死亡原因及变化趋势。方法 收集2005~2014年解放军总医院老年病房(包括老年心血管内科、神经内科、呼吸内科、消化内科、肿瘤内科等)≥60岁住院死亡患者1130例的疾病分类报表,其中男性1067例,女性63例,年龄(87.24±6.76)岁,按照年龄分为4组,60～69岁组32例,70～79岁组86例,80～89岁组578例,≥90岁组434例,分析不同年龄组患者死亡原因、顺位情况及变化趋势。结果 近10年老年住院患者死亡原因前三位系统疾病依次为肿瘤426例(33.7%)、呼吸系统疾病375例(33.19%)和循环系统疾病191例(16.90%),下呼吸道感染(32.12%)、肺癌(12.04%)和冠心病(9.03%)是前三位单病种疾病,肿瘤、呼吸系统疾病分别是<90岁和≥90岁患者死亡的首位原因。近5年死亡患者中>90岁组构成比显著升高(χ²＝34.70,P<0.001)。结论 肿瘤、呼吸和循环系统疾病是我院老年住院患者死亡的三大系统疾病,尤其要重视下呼吸道感染、肺癌和冠心病的综合防治。

Abstract:

Objective To analyze the causes of death and their trends in the elderly patients hospitalized in our hospital in recent 10 years. Methods Death certificates of 1130 over-60-year-old inpatients who died in the geriatric wards (including the departments of geriatric cardiology, neurology, respiratory diseases, gastroenterology and oncology) of our hospital during the period were collected and classified by the International Classification of Diseases (the Tenth revision, ICD-10) in this study. They were 1 067 males and 63 females, and at an aged of (87.24±6.76) years. They were divided into 4 age groups, that is, 60-69 (n=32), 70-79 (n=86), 80-89 (n=578) and over 90 years old groups (n=434). The causes of death, ranking and trend were analyzed among the different age groups. Results The 3 leading causes of death were neoplasms (n=426,3.7%), respiratory system diseases (n=375,3.19%), and circulatory system diseases (n=191,6.90%) in order. The most common diseases of causing death were lower respiratory tract infection (32.12%), lung cancer (12.04%) and coronary heart diseases (9.03%). Neoplasms and respiratory system diseases were the leading causes of death for the patients younger than 90 and those over 90 years old, respectively. The constituent ratio of the over-90-year-old group was significantly increased during the past 5 years (Chi square=34.70, P<0.001). Conclusion Neoplasms, respiratory system and circulatory system diseases are the top 3 major causes of death in the elderly from our hospital. Particular emphasis should be placed on the comprehensive prevention and treatment for lower respiratory tract infection, lung cancer and coronary heart diseases.