摘要
目的对住院老年患者死因进行分析,寻找≥80岁患者死亡原因的特点和规律,为临床治疗和管理高龄患者提供指导和依据。方法利用计算机电子病历系统查找2005年1月至2014年6月期间在四川省人民医院心血管内科和老年科年龄>65岁住院患者的死亡病历1684例。按照死亡年龄分为≥80岁组(n=997)和<80岁组(n=687),再依据性别分别进行亚组分析。按照治疗科室分为心血管内科组(n=820)和老年科组(n=864),再依据年龄分别进行亚组分析。结果≥80岁组男性组的住院时间显著长于≥80岁组女性组,<80岁组男性组的住院时间显著长于<80岁组女性组,差异具有统计学意义(P<0.001)。组间比较结果显示,≥80岁男性组中以呼吸道感染为死因者显著高于<80岁男性组,而以脑血管疾病为死因者显著低于<80岁男性组;≥80岁女性组中以呼吸道感染为死因者显著高于<80岁女性组,而以心脑血管疾病为死因者显著低于<80岁女性组;老年科≥80岁组中以呼吸道感染和恶性肿瘤为死因者显著高于心血管内科≥80岁组,而以心脑血管疾病为死因者显著低于心血管内科≥80岁组;老年科<80岁组中以呼吸道感染和恶性肿瘤为死因者显著高于心血管内科<80岁组,而以心脑血管疾病为死因者显著低于心血管内科<80岁组,差异均具有统计学意义(P<0.05)。组内比较结果显示,≥80岁男性组中以呼吸道感染为死因者显著高于≥80岁女性组;≥80岁男性组中以心脑血管疾病为死因者显著低于≥80岁女性组;心血管内科≥80岁组中以呼吸道感染为死因者显著高于心血管内科<80岁组,而以心脑血管疾病为死因者显著低于心血管内科<80岁组;老年科≥80岁组中以呼吸道感染为死因者显著高于老年科<80岁组,而以恶性肿瘤为死因者显著低于老年科<80岁组,差异均具有统计学意义(P<0.05)。结论≥80岁住院患者受呼吸道感染死亡威胁增加,尤其对于≥80岁男性危害最明显,而心脑血管疾病导致的死亡人数相对下降。
Objective To investigate the characteristics and patterns of causes of death in the hospitalized senile adults in order to provide the evidence and guidance for the clinical treatment and management of patients over 80 years old.Methods A total of 1684 death records of the hospitalized patients aged 65 years or older admitted in our cardiological and geriatric departments from January 2005 to June 2014 were collected from the digital medical records system.They were divided into the ≥80-year-old group （n=997） and the 〈80-year-old group （n=687）, and further divided into different gender subgroups.They were also divided into the patients from the cardiological department （n=820） and those from the geriatric department （n=864）, and further assigned into different aged groups.Results The lengths of hospital stay were significantly longer in the males than the females from the ≥80-year-old group, so were in the 〈80-year-old group, with significant differences between the 2 genders （P〈0.001）.The mortality due to respiratory tract infection was obviously higher, but that due to cardiocerebral vascular diseases was remarkably lower in the males over 80 years old than those younger.Similar results were observed in the female patients.There were more ≥80-year-old patients died from respiratory tract infection and malignant tumor, but less patients died from cardiocerebral vascular diseases among those from the geriatric department than those from cardiological department.For the patients younger than 80 years old, those from the geriatricdepartment had higher mortality due to respiratory tract infection and malignant tumor, but lower death rate of cardiocerebral vascular diseases than those from the cardiological department （P〈0.05）.The ≥80-year-old male patients had higher mortality of respiratory tract infection, but lower mortality of cardiocerebral vascular diseases than the same-aged female patients.Among the patients from the cardiological department, those aged 80 or older had higher death rate of respiratory tract infection but lower rate of cardiocerebral vascular diseases than those younger （P〈0.05）.For the geriatric patients, the aged 80 or older had higher mortality of respiratory tract infection, but lower rate of malignant tumor than those younger （P〈0.05）.Conclusion Respiratory tract infection threatens the over 80-year-old patients, especially for the males.But the threat from cardiocerebral diseases is decreased comparatively.
作者
王文艳
盛勇
辜晓惠
陈晓涵
奉婷
WANG Wen-Yan SHENG Yong GU Xiao-Hui CHEN Xiao-Han FENG Ting(Heart Failure Center Department of Geriatric Cardiology, Siehuan Provincial People＇ s Hospital, Siehuan Provincial Academy of Medical Sciences, Chengdu 610072, China)
出处
《中华老年多器官疾病杂志》
2017年第4期261-264,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
四川省干部保健委员会项目(2013-203)~~
关键词
老年人
死亡原因
住院
呼吸道感染
心血管疾病
脑血管疾病
aged
cause of death
hospitalization
respiratory tract infections
cardiovascular diseases
cerebrovascular diseases
