| Objectives With the continuous improvement of the level of science,technology,social economy and the continuous progress of medical and health in our country,the health status of residents has been significantly improved,and the total mortality rate was decreasing year by year.The main diseases that lead to death also changed.By describing the disease composition and distribution of hospitalized dead patients in a second-class hospital in Qinhuangdao from 2013 to 2018,the main diseases seriously affecting the health of inpatients were found.To analyze the composition and sequence of death causes of hospitalized patients,and to understand the changes of death spectrum of inpatients,The dynamic changes of case fatality rate of inpatients from 2013 to 2018 were analyzed to provide reference for hospitals to strengthen diagnosis and treatment,scientific management and rational allocation of medical resources.Methods The data of inpatients and dead patients in a second-class hospital from 2013 to 2018 were analyzed retrospectively.The medical records of hospitalized dead patients among 6 years were collected from HIS.Every record was examined and verified.The cause of death is classified according to the International Classification of Diseases(ICD-10).If there are two or more diagnoses,the first diagnosis of discharge is taken as the cause of death.The database was established with Microsoft Excel 2010.The composition,sequence and mortality of the cause of death in the hospital were statistically described and analyzed by this software.Results Among the 1691 hospitalized deaths,the top five causes of death were malignant tumors(33.47%),circulatory diseases(30.40%),respiratory diseases(16.44%),digestive system diseases(5.91%)and endocrine system diseases(2.78%).Accounted for 89.00% of all causes of death.Lung cancer,liver cancer and gastric cancer are the main causes of death of malignant tumors,cerebral infarction,cerebral hemorrhage and coronary heart disease are the main causes of death of circulatory system,pneumonia,chronic obstructive pulmonary disease and respiratory failure are the main causes of death of respiratory diseases.The order of the causes of death in the hospital changed from 2013 to 2018.The causes of death in 2013 were circulatory system diseases,malignant tumors,respiratory system diseases,urinary system diseases and digestive system diseases.The order of causes of death in 2018 were malignant tumors,circulatory system diseases,respiratory system diseases,digestive system diseases and endocrine system diseases.The malignant tumor rose to the first place,the endocrine system disease rose to the fifth place,and the urinary system disease dropped out of the top five.However,malignant tumors,circulatory diseases and respiratory diseases have been the top three causes of death in this hospital.Because there was no neonatal department of pediatrics in this hospital,so there were fewer patients who died before 14 years old.As a result,due to lack of statistical data,it was impossible to carry out statistical analysis.The first three causes of death were all malignant tumor,circulatory system disease and respiratory system disease in over 15 years old group,over 45 years old group and 60?105 years old group,and there only exist difference in the fourth and fifth place.The case fatality rate of inpatients from 2013 to 2018 was 1.59%,the case fatality rate of inpatients in 2013 was 1.84%,and that of hospitalization in 2018 was 1.56%.It showed a downward trend from 2013 to 2018.The case fatality rate of urban residents is 2.01%,and that of rural residents is 1.01%.The case fatality rate of urban residents was higher than that of rural areas.The case fatality rate increased with age,and the lowest case fatality rate is 0.06% in the 0?4 years old group,and the highest case fatality rate is 2.83% in the over 60 years old group.The overall case fatality rate was 1.60%.The disease with the highest fatality rate is malignant tumor(8.84%),followed by respiratory diseases(3.38%),circulatory diseases(1.73%).Although diseases such as infectious diseases and parasites rank tenth in the order of causes of death,they are already the fifth in terms of case fatality.Conclusions 1.The case fatality rate of inpatients in this hospital showed a downward trend from 2013 to 2018.2.The causes of death position were malignant tumor,circulatory system disease,respiratory system disease,digestive system disease and endocrine system disease.The causes of death and its position changed in order,all of which were chronic non-infectious diseases.3.Among the first three causes of death,lung cancer is the main cause of death in malignant tumors,cerebral infarction is the main cause of death in circulatory diseases,and pneumonia is the main cause of death in respiratory diseases.4.The order and composition of the causes of death of hospitalized patients also changed with the changes of age,sex,season and days of hospitalization.The older the age,the higher the case fatality rate,and the number of deaths over the age of 60 accounted for 83.92% of the total.Among all the patients who died in hospital,the number of males in the endocrine system was less than that of females,and the number of males in other systemic diseases was more than that of females.In the grouping of hospitalization days,the number of patients who died in hospital more than 20 days was higher,and the number of patients who died in hospital within 1 day was the second.The case fatality rate in winter was higher than that in spring,summer and autumn.Table 20;Reference 52... |
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