| Objective:To understand the epidemiology characteristics of emergency death cases. Raise the success rate of rescue of critical cases in emergency department. And provide the basis for preventing.Methodology:Data of the 1052 death cases (except the Gynecology and Obstetrics cases) at an age of 14 or above from October,2000 to October,2010 in the Emergency Department of the 5th Central Hospital of Tianjin were collected, including:gender, age, cause of final death, date of death including concreteness time. All the data were analyzed using SPSS 16.0. The gender ratio of the whole cases, the sudden death cases and the not sudden cases was calculated. Chi-square test was used to find the gender differences between the sudden death group and the not sudden death group, P<0.05 was defined having statistic difference. According to age, all the cases were divided into low age group (14-19 years old), high age group (>90 years old), and the age between was divided into 7 groups using 10 years as a criteria. The percentage of each group was calculated. T test was used to find out the age difference between the sudden death group and the not sudden death group. P<0.05 was defined having statistic difference. The sudden death group and the not sudden death group were divide into sub-groups using the criteria of death causes, the percentage of each death cause was calculated of both sudden death group and the not sudden death group. The number of the death cases of each season was calculated and the percent of each season was calculated. The percentage of each death causes among the whole cases were calculated of every season group. A day time was divided into 00:01-06:00,06:01-12:00,12:01-18:00 and 18:01-24:00, the number of the each death cause during each time period was counted and the percentage of each group among the whole cases was calculated. The percentage of each period among the whole cases was calculated.Results:During the 1052 cases, there were 657 male patients and 395 female patients, the ratio between the male patients and female patients is 1.66:1. The maximum age of the death cases is 93 while the minimum age is 15 with the average age 56.72±18.05. Age 50-79 had high incidence of emergency death, and 70-79 had the highest incidence which accounts of 27.95%; The group of age 60-69 and 50-59 had the second highest incidence. The group of age below 20 and over 80 had relatively less cases which account only 8.94% among the whole cases. The group of age 30-59 had significant differences between gender, the ratio between the male patients and female patients was 3.33:1, while in the group of 20-29 and over 80, there were more female patients, the ratio between the male patients and female patients was 1:1.15. Compared with not sudden death group, male patients accounted more (p=0.001). The three leading causes of emergency death were cardiovascular diseases, gastrointestinal diseases and cerebrovasular diseases, and the percentage of these three death causes among the whole case were 27.67%,15.87% and 14.73% respectively. Among the sudden death group, the three leading causes were cardiovascular diseases, gastrointestinal diseases and cerebrovasular diseases, which accounted for 43.93%,15.89% and 19.63% respectively. Among the not sudden death group, the three leading death causes were trauma, cardiovascular diseases and the cerebrovascular disease, which accounted for 19.71%,16.51% and 15.86% respectively. The first season and the fourth season had the high incidence of emergency death and the sudden death, the death and the sudden death cases are 608 patients and 259 patients which accounts for 57.79% and 60.15% respectively among the emergency cases and the sudden death cases. The leading causes of death of the first season were cardiovascular, cerebrovascular diseases and respiratory diseases; the leading death causes of the second season were cardiovascular diseases, gastrointestinal diseases and cerebrovascular diseases; the leading death causes of the third season were cardiovascular diseases, gastrointestinal diseases and the cerebrovascular diseases; the leading death causes of the fourth season were cardiovascular diseases, cerebrovascular diseases and the respiratory diseases. 00:01-06:00 had the high incidence of emergency death and sudden death, which had a percentage of 30.8% and 31.54% respectively; 06:01-12:00 and 00:01-06:00 had the highest incidence of cardiovascular death; 00:00-06:00 had the highest incidence of cerebrovascular death, respiratory death and gastrointestinal death; 12:01-24:00 had the highest incidence of acute poisoning death.Conclusion:(1) There was gender difference of emergency death. Male emergency cases had a higher risk of death for male patients often faced with press, cardiovascular risk factors such as smoking, alcohol use and lack of estrogen which can protect the vascular. So, education was needed for male patients and unhealthy lifestyle should be quitted. (2) Most emergency death cases were middle age and aged patients. The group of middle age and aged patients had a high incidence of cardiovascular and cerebrovascular sudden death. Multiple organ function of aged patients often declined, also the declined organ reserve function. Under the acute hit, it is easily developed into multiple organ dysfunction and multiple organ dysfunction syndrome in the elderly (MODSE) which could cause death. (3) The three leading causes of emergency death were cardiovascular diseases, cerebrovascular diseases and gastrointestinal diseases; the three leading causes of emergency sudden death causes were cardiovascular diseases, gastrointestinal diseases and cerebrovascular diseases; the causes of not sudden death causes were trauma, cardiovascular diseases and cerebrovascular diseases. (4) The first season was the aggravated season for cardiovascular diseases, cerebrovascular diseases and respiratory system diseases. And also was the season which had a high incidence of emergency death and sudden death. (5) 00:01-06:00 was the time period which had the high incidence of emergency death and sudden death. For the raised tension of vagus, low concentration of the stress hormones such as the glucocorticoid and low ability under stress... |
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