老年住院手术患者疾病谱变化趋势和疾病构成的帕累托图分析

目的探讨近5年老年手术患者疾病谱顺位和疾病构成情况,以期有助于改进医院管理、加强老年人的疾病防治、提升老年人的生活质量。方法依据ICD-10按出院主要诊断进行疾病分类,采用疾病构成比及帕累托分析法对病例资料进行疾病谱和疾病构成分析,采用SPSS 16.0、EPI 6.04对数据进行统计学检验。结果近五年老年手术患者比例有逐年上升的趋势(P0.05);各年间的疾病谱顺位存在一致性(P0.05);肿瘤、泌尿生殖系统疾病、消化系统疾病、循环系统疾病是构成老年手术患者的主要疾病(A类)。结论针对老年人群社会应加大对肿瘤、泌尿生殖系统疾病、消化系统疾病、循环系统疾病的关注,医院要加强相应的手术管理工作,尤其要深入开展肿瘤的三级预防,提升老年人的生活质量。     

2003--2012年某院住院患者疾病构成分析

目的：对某院住院患者疾病构成和年龄分布进行分析,掌握该院患者疾病的规律和特点,为医院管理提供依据。方法统计该院2003-2012年住院患者前10位疾病,对疾病构成和患者年龄分布进行分析。结果该院2003-2012年住院患者前10位疾病收治204587人次,占住院患者总数的90．9％。前10位疾病依次是呼吸系统疾病、消化系统疾病、循环系统疾病、妊娠分娩和产褥期疾病、损伤与中毒、泌尿生殖系统疾病、传染病和寄生虫病、肿瘤、起源于围生期的某些情况、内分泌及营养代谢疾病。结论对这10类疾病的诊断、治疗和护理应成为该院医疗工作的重点,尤其是呼吸系统疾病、消化系统疾病、循环系统疾病、妊娠分娩及产褥期病、损伤和中毒、泌尿和生殖系统病。     

某医院城镇职工基本医疗保险患者住院疾病构成的帕累托图分析

目的 掌握医院城镇职工基本医疗保险患者住院疾病谱的基本情况,探讨该医院住院患者的疾病构成,为医院管理部门做好基本医疗保险患者管理工作提供依据.方法 应用帕累托法则对2009年1月至2010年8月底出,院的城镇职工基本医疗保险患者疾病按ICD-10一级分类进行统计.结果 统计疾病分类的区间内有6个疾病病种占全院出院病种的86.72％,依次是:循环系统疾病、肿瘤、消化系统疾病、呼吸系统疾病、内分泌及营养和代谢疾病、泌尿生殖系统疾病.结论 得到该医院沈阳市城镇职工基本医疗保险患者就医疾病谱,可以有针对性地对该医院相关科室的工作人员加强医保政策的宣教,更好地为沈阳市城镇职工基本医疗保险患者提供优质的服务.     

2000-2008年我院住院病人疾病构成分析

目的通过对我院2000-2008年9年问前10种疾病住院病人的分析,了解本地区各种疾病的发病情况,提高医院诊疗的质量。方法按照我院出院病人数,对排在前10位的疾病按出院年份分组进行构成比和顺位分析。结果排在前10位的疾病分别是损伤与中毒、肿瘤、呼吸系统疾病、妊娠分娩和产褥期疾病、消化系统疾病、泌尿生殖系统疾病、循环系统疾病、传染病和寄生虫病、肌肉骨骼结缔组织疾病和神经系统感觉器官疾病。结论必须广泛开展常见疾病的科普宣传,不断提高人民群众的医疗保健知识和自我保健能力。     

某院2009—2013年住院患者疾病构成分析

目的：分析2009—2013年某院病人的疾病构成,为医院持续发展提供决策参考数据。方法根据国际疾病分类标准,对2009—2013年住院病人的疾病构成,按顺位、性别、区域外患者比例分别进行统计分析。结果泌尿生殖系统疾病、妊娠,分娩和产褥期等出院人次构成比及区域外患者构成比都比较高。结论医院加强重点专科建设与中医治未病管理,发挥中医中药特色,提高医院竞争力,促进医院可持续发展。     

某院2006-2008年住院病人疾病构成分析

目的 了解某院住院病人疾病构成及变化趋势,为医院合理地配置卫生资源,完善医院管理方式,满足人民群众防病治病提供理论依据. 方法 对比分析2006-2008年某院住院病人疾病构成及顺位变化. 结果 前10位疾病占住院疾病的90%左右,分别为:损伤和中毒、呼吸系统疾病、妊娠、分娩和产褥期疾病、循环系统疾病、消化系统疾病、肿瘤、影响健康状态和与保健机构接触的因素、泌尿生殖系统疾病、肌肉骨骼系统和结缔组织疾病、眼和附器疾病,其中呼吸系统疾病位次逐年上升. 结论 根据某院疾病构成情况,加强重点科室建设,提高医院医疗诊断、治疗、服务水平,提高医院竞争力.     

2014—2018年妇科出院患者疾病构成分析

目的分析某院2014—2018年妇科出院患者疾病构成现状,为开展本地区妇科常见病的预防和医疗保健工作提供依据。方法对该院2014—2018年妇科出院患者进行回顾性分析。结果妇科出院患者中,位列前3位系统疾病依次是妊娠、分娩和产褥期(40.59%),泌尿生殖系统疾病(33.56%),肿瘤(16.63%)。妊娠、分娩和产褥期疾病前5种分别是异位妊娠、医疗性引产、稽留流产、先兆流产和自然流产;泌尿生殖系统疾病前5种分别是生殖道息肉、子宫其他非炎性疾患、子宫内膜异位、输卵管炎和卵巢炎;肿瘤前5位是子宫平滑肌瘤、卵巢良性肿瘤、宫颈原位癌、宫颈恶性肿瘤和子宫体恶性肿瘤。结论异位妊娠、医疗性引产、子宫平滑肌瘤、子宫息肉等为妇科常见病。基于常见疾病,应提高保健知识宣传和体检筛查力度,积极治疗早期疾病,降低妇科疾病发病率。     

某医院2018年住院患者疾病构成及帕累托图分析

目的对某三甲医院2018年住院患者疾病构成特征进行分析,为医院在疾病防治、合理配置医疗资源及进一步研究等方面提供依据。方法提取医院病案信息管理系统中2018年1月1日至2018年12月31日全部住院患者病案首页信息。以主要诊断为依据,按照ICD-10标准进行疾病分类统计,并用帕累托图分析疾病构成情况,采用SPSS 22.0统计软件进行数据整理与分析。结果该院2018年住院患者共计38149人次,男性20859人次,女性17290人次,男女比为1.21∶1;≥60岁老年患者21269人次,占55.75%;前7类主要系统疾病占总体的76.05%,依次是呼吸系统疾病、循环系统疾病、消化系统疾病、泌尿生殖系统疾病等;不同性别、不同年龄组的疾病分布不同(P<0.05)。结论该院住院患者疾病构成具有自身特点,应加强疾病顺位前几位疾病的诊疗水平,加强重点专科建设,重点关注老年患者的慢性病问题。     

某院2004-2008年住院病人前10位疾病构成统计分析

目的通过对某院2004--2008年住院病人前10位疾病构成分析,为医院管理及疾病防治工作提供决策依据。方法对该院2004-2008年出院病人疾病分类报表按国际疾病分类标准ICD-10进行整理、统计、分析。结果该院2004--2008年前10位疾病依次为肿瘤、损伤和中毒、循环系统疾病、消化系统疾病、呼吸系统疾病、泌尿生殖系统疾病、为特殊治疗住院、妊娠分娩和产褥期疾病、传染病和寄生虫病、眼和附器疾病,近2年起源于围产期疾病跃居前10位;前10位疾病占全院收治总量的84．45％～86．08％;肿瘤始终稳居第1位,循环系统疾病有上升趋势。结论做好这些疾病的诊断、防治工作应成为该院工作的重点。     

2004-2008年我院出院病人疾病构成分析

目的 通过对我院2004-2008年出院病人疾病构成及疾病谱进行分析,了解本院乃至本地区主要疾病的构成情况及发展演变规律. 方法 对我院2004-2008年出院病人疾病分类报表资料进行整理、统计、分析. 结果 我院出院病人疾病前5位依次是肿瘤、影响健康状态与保健机构接触的因素、循环系统疾病、泌尿生殖系统疾病、消化系统疾病. 结论 加强对这5类疾病的诊断、治疗及护理应成为我院乃至本地医疗卫生预防工作的重点,以提高人民的健康水平和生命质量.     

循环系统疾病的发病规律及其预测模型

目的讨论循环系统疾病(高血压、心肌梗死和脑卒中)发病的月和年际变化规律及与气象因素的关系,并建立月发病气象预测模型。方法利用2000—2008年乌鲁木齐市循环系统疾病逐月发病人数资料分析其变化规律,结合同期地面气象A文件资料中气温、气压、日照时数、总云量、相对湿度、平均风速等因子进行相关分析和逐步回归分析。结果循环系统疾病发病人数逐年呈现上升态势,2000—2004年变化相对平稳,高值年出现在2008年;春季病多发,秋冬季最少;高发期为单峰双月型,低发期为双峰单月型;利用旬预测模型F检验,趋势拟合准确率高血压SS=59%,脑卒中SS=63%、心肌梗死SS=83%。结论可结合未来旬天气预报进行循环系统疾病发生趋势预测,为采取针对性的预防循环系统疾病发生的措施提供依据。     

2000-2004年云南某锡矿工人肺癌发病死亡分析

目的了解锡矿工人肺癌发病死亡情况,为矿工肺癌的预防和控制提供科学依据。方法对2000-2004年锡矿工肺癌发病率死亡率分布特征进行流行病学回顾分析,比较各年的发病率和死亡率的变化。结果2000-2004年该锡矿工人肺癌发病率和死亡率均呈下降趋势,2000年发病率由410.50/10万降至2004年390.95/10万,死亡率由356.66/10万降至342.08/10万。结论锡矿工是肺癌高发的职业之一,仍需要进一步做好锡矿工人劳动防护的工作,让工人能在更加安全的环境下工作。     

肿瘤患者医院感染相关因素的调查

目的了解肿瘤患者医院感染发病情况,以制定有效的防控措施。方法回顾性调查2000~2004年住院病历25 005份,逐份进行查阅分析。结果5年出院25 005例,发生医院感染1 238例(1 376例次),感染率为5.0%(5.5%),各感染部位以呼吸道为最高46.8%,医院感染与年龄、住院时间、原发肿瘤疾病、死亡率等有关,化疗科医院感染率最高7.9%,明显高于外科、放疗科;真菌感染率呈逐年上升趋势。结论必须持续改进、落实医院感染的监控措施,特别是化疗、放疗、呼吸道感染和真菌感染患者的重点监测和管理。     

Clinical epidemiology of primary lung cancer in Tunisia. 100 cases

BACKGROUND: Lung cancer is frequent and its incidence is increasing inTunisia and in all over the world. Few published Tunisian studies have described epidemiology of lung cancer. AIM: To report the clinical features and outcomes of lung cancer in Tunisia from a retrospective review of 100 consecutive patients seen in F.S.I. hospital in La Marsa. METHODS: a retrospective study was carried out 100 cases of bronchial carcinoma seen in pulmonology department between 2000 and 2004. We analysed diagnosis modalities, histological subtypes, staging of the disease, treatment strategies and survival. Survival rates were calculated using Kaplan-Meier method. RESULTS: mean age was 59.5 years,sex-ratio at 19.92% of patients were smokers; the average of tobacco consumption was 48.5 PY. The diagnosis was histologically proven in 90% of the cases. Specimen were obtained by bronchoscopy (53.4% of cases), fine-needle lung biopsy (30%), metastasis biopsy (7.7%), surgical biopsy (7.7%) and more rarely by thoracoscopy (1.2%). Histologically, 39% were squamous carcinomas, 30% adenocarcinomas and 8.7% small cell carcinomas. 51% of non small cell lung carcinomas were stage IV, 26% stage IIIB, 9% stage IIIA and 14% were stage I or II. 6 of 10 patients with small cell carcinomas were with disseminated disease. 18 of 21 patients with resectable tumors receive surgery. Patients with locally advanced tumors received combined chemotherapy and radiotherapy. 14 of 46 stage IV patients received palliative chemotherapy. Survival rate was 18% at 2 years.     

Monitoring the occurrence of wound infections after cardiac surgery

The aim of this study was to demonstrate the use of a graphical method for real-time monitoring of the occurrence of surgical wound infection following cardiac surgery. This included developing and incorporating a risk scoring system so that variations in case-mix could be duly accounted for in the monitoring process. We analysed routinely collected data from a London teaching hospital. These data consisted of records for 2146 patients who had undergone cardiac surgery between April 2000 and March 2004 and whose surgical wounds were followed up as part of the local surveillance programme. The risk model was developed using logistic regression analysis with surgical wound infection diagnosed before hospital discharge as the outcome measure. Factors included in the model were the number of surgical wounds, patient age, operations that combined bypass surgery and valve replacement, renal disease and the number of days between hospital admission and surgery. The model was a good predictor of outcomes recorded within an independent data set (Chi-squared=3.81, P=0.58) and we incorporated it into a graphical tool for monitoring outcomes. The risk model and the associated graphical monitoring method could be valuable tools to assist with infection management. If used in real-time, problems with the care process can be quickly identified allowing timely remedial action to be taken.     

The incidence and cost of cardiac surgery adverse events in Australian (Victorian) hospitals 2003–2004

The aim of this study was to estimate the incidence of adverse events in acute surgical admissions for cardiac disease in admitted episodes in the year 2003–2004 and to estimate the cost of these complications to the Victorian health system. Cardiac surgery adverse events are among the most frequent and significant contributors to the morbidity, mortality and cost associated with hospitalisation. Patient-level costing data set for major Victorian public hospitals in 2003–2004 was analysed for adverse events using C-prefixed markers, denoting complications that arose during the course of hospital treatment for cardiac surgery diagnosis related groups (DRGs). The cost of adverse events was estimated by linear regression modelling, adjusted for age and co-morbidity. A total of 16,766 multi-day cardiac disease cases were identified, of whom 6,181 (36.85%) had at least one adverse event. Patients with adverse events stayed approximately 7 days longer and had four times the case fatality rate than those without. After adjustment for age and co-morbidity, the presence of an adverse event adds AUS$5,751. The sum of the total cost of adverse events for each DRG was AUS$42.855 million, representing 21.6% of total expenditure on cardiac surgery and adding 27.5% in broad terms to the cardiac surgery budget.      

龙岩市2000～2004年性病疫情特征分析

[目的]了解性病的流行趋势和特点，为制定防治措施提供科学依据。[方法]对龙岩市2000-2004年性病疫情资料进行分析。[结果]2000～2004年累计报告性病9044例，年均发病率为63．10／10万，2001年高达85.65／10万。病例中，淋病占47．42％，尖锐湿疣和非淋菌性尿道炎分别占16．70％和15．36％；男性5926例，女性3118例；20-29岁、30-39岁分别占30．38％、40．33％；季节分布以秋季为多，其次是夏季和冬季，分别占全年度的33.09％、27.30％和23．35％；地区分布以新罗区最多，占发病总数的35．12％，其次是上杭县，占21．48％。非婚性接触传播占75.72％，静脉吸毒传播占0．01％，经血液传播者占0．02％。[结论]龙岩市性病发病维持在较高水平，防治工作任重道远。     

Impact of a six-year control programme on surgical site infections in France: results of the INCISO surveillance

Surgical site infections (SSI) are a key target of nosocomial infection control policy. We evaluated the impact of a six-year surveillance system based on data from INCISO, a network of volunteer surgical wards from hospitals in Northern France. Each year surgical patients were enrolled consecutively and surveyed during their in- and out-hospital stay until 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria and several risk factors such as wound class, American Society of Anesthesiologists score, operation duration, elective/emergency, videoscopy and type of surgery. A dashboard was displayed at the end of each annual survey, so that participants could compare with other surgery adjusted for National Nosocomial Infections Surveillance system (NNIS) risk index and standardised incidence ratio (SIR). Over the six years, 3661 SSI were identified in 150 440 surgical patients (crude incidence: 2.4%) from 548 surgery wards. The crude SSI incidence decreased from 3.8 to 1.7% (P for trend <0.0001, relative reduction: -55%) and the NNIS-0 adjusted SSI incidence from 2.0 to 1% (P for trend <0.0001; relative reduction: -50%). An active surveillance system striving for benchmark through a network is an effective strategy to reduce SSI incidence. Sustaining control efforts have to be made to maintain low SSI level beyond the three primer years.     

2000~2004年住院病人死因分析

目的探讨我院1714例住院病人的死亡原因及其变化趋势。方法收集2000~2004年住院死亡病案1714份,对其病死率、死因构成等进行统计分析。结果死因构成的前5位分别是:损伤和中毒、肿瘤、循环系统疾病、呼吸系统疾病、消化系统疾病,占82·79%。结论加强死因顺位前5位疾病的防治工作,可降低住院病死率,提高居民的健康水平和生命质量。