住院老年肿瘤患者185例死亡病例分析

目的探讨老年恶性肿瘤住院患者死亡情况及危险因素。方法对1993年1月1日至2006年12月31日期间住院的老年恶性肿瘤死亡病例进行回顾性分析。结果（1）14年间因恶性肿瘤死亡患者185例，其中以肺癌59例（31．9％）、肝癌31例（16．8％）、结直肠癌1例（11．4％）为前三位主要死因。1993～1999年因恶性肿瘤死亡患者62例（33．5％），2000-2006年死亡肿瘤患者123例（66．5％）。（2）合并感染病例126例，占全部肿瘤死亡病例的67．7％，104例患者的死亡与感染有关，感染直接引起死亡13例（7．0％），间接引起死亡91例（49．2％）。（3）恶性肿瘤合并老年多脏器功能衰竭（MOF）91例（49．2％），各脏器出现功能衰竭的时间顺序依次为呼吸系统、肾脏、肝脏、血液系统、神经系统、胃肠系统、心血管系统。各脏器功能衰竭的频率顺序为肺脏、心脏、肝脏、神经系统。（4）分析住院天数、是否合并感染、感染部位数目、感染次数、转移部位数目、合并基础疾病数目等因素对MOFE的影响中，显示基础疾病数目、感染部位数目是MOF的危险因素。结论恶性肿瘤患者死亡人数逐年上升，感染、MOF等并发症已成为肿瘤患者死亡的主要原因。

Hospital death of aged tumor patients: analysis of 185 cases

Objective To explore the risk factors for and the main death causes of aged tumor patients in hos- pital.Methods The elderly eases died during January 1st 1993 to December 31st 2006 in this hospital were reviewed using the pre-designed form.Results (1) The main death causes of 185 aged patients died of malignant tumors dur- ing this 14 years were lung cancer 59 (31.9%),hepatocellular carcinoma 31 (16.8%),colorectal cancer 21 (11.4%). (2)The number of the cancer patients having infection was 126,accounting for 67.7% of all dead tumor patients.A- mong them,infection was direct cause of death in 13 patients and indirect cause of death in 91 patients.(3)The num- ber of deaths in the senile tumor patients with multiple organ failure (MOF) was 91(49.2%).The time order of oc- currence of organ failure was respiratory system,kidney,liver,hemopoietic system,nervous system,gastrointestinal system and cardiovascular system.The order of freguency of failure was lung,heart,liver and nervous system.(4) The number of underlying diseases and number of infection sites were main risk factors for MOF in the elderly.Con- clusion The number of aged people died of malignant tumors has increased year by year.Infection and MOF have become the main causes of death in patients with tumors.