住院老年恶性肿瘤患者的死亡分析研究

目的对我院近4年收治的住院老年恶性肿瘤死亡患者的病案资料进行回顾性调查和统计分析，探讨老年恶性肿瘤死亡分布的特征、死亡原因等，以提供临床医生制定相应的防治措施依据。方法从2009年1月～2012年12月收住我院的病案数据库中收集〉60岁老年恶性肿瘤死亡患者的资料，根据ICD-10进行死因分类并流行病学分析，计算年病死率、分析研究其年龄分布、性别与病种的分布、合并症情况、死亡月份的分布、死亡原因。结果随着年龄的增加，病死率逐渐增加，在70～80岁年龄组达到高峰；60～70岁年龄组随着时间的推移，逐年死亡发生率下降，而70岁以上年龄组则发生率逐年增加；前五位的病种依次为：肺癌、肝癌、大肠癌、胃癌、头颈部癌。在男性，前五位的病种依次为：肺癌、胃癌、大肠癌、肝癌、头颈部癌；在女性，前五位的病种依次为：肝癌、大肠癌、胃癌、头颈部癌、胰胆管癌。大多病种死亡人数男性多于女性；合并症大多为老年性痴呆、脑萎缩、心血管病、糖尿病、前列腺增生、肺部感染；死亡月份的分布显波浪状曲线，2月份达到第一个高峰，8月份达到第二个高峰；主要死于全身多器官衰竭、呼吸衰竭、消化道出血、肝性脑病、肠梗阻。结论对老年恶性肿瘤住院患者的病情及各种影响因素应进行充分的评估，采用有效的综合防治措施，以使患者得到改善症状，提高生存质量，延长生存期。

Analysis and research of death in elderly malignant tumor patients in hospital

Objective To retrospectively study the patients＇clinical characteristics,annual and monthly mortality rates and the causes of death of geriatric oncqlogy patients who were expired in Xiamen First Hospital during the last four years so that we can provide clinicians some useful information to modify their clinical practice and improve patient care. Methods We examined the hospital inpatient database from January 2009 to December 2012 for all patients with a cancer diagnosis who were older than 60 year and expired during the hospitalization. These patients were classified according to ICD10 cause of death classification and then statistically analyzed the annual and monthly mortality rates,age,gender,primary cancers, comorbid conditions and causes of death. Results Our study showed that the mortality rates increased with age,highest mortality group is the 7o to 80 age group.The annual mortality rates had decreased for the group of age 60 to 70. But for 70 and older group,the annual mortality rates had been increasing. The five most common malignancies were the cancers of lung,liver,colon,stomach and head and neck.For men, the five most common cgncers are lung cancer,stomach cancer,colon cancer,liver cancer and head and neck cancer, while for women,they were liver cancer,colon cancer, stomach cancer,head and neck cancer,and pancreatic and cholangiocarcinoma.The male mortality was higher than female.The common comorbid conditions were Alzheimer＇ s disease,brain atrophy,cardiovascular diseases,diabetes,benign prostate hypertrophy, and pneumonia. There were two peaks in the wave shape monthly mortality curve,the first one was in February and the 2nd peak was in August.The main causes of death weie multiple organ failure,respiratory failure, gastrointestinal bleeding,hepatic encephalopathy,and bowel obstruction. Conclusion we have identified the most common malignancies,comorbid conditions and causes of death of geriatric oncology patients who expired in our hospital,which are important for clinicians to design and implement appropriate and effective measurements to improve symptom control,quality of life and survival of these patients.