老年糖尿病住院患者死亡原因分析

目的 了解老年糖尿病患者的死亡原因。方法 对1995年1月~2002年12月在我院住院并死亡的老年糖尿病患者183例的临床资料进行回顾性分析,并与同期非糖尿病住院并死亡的老年患者292例相对照。结果 老年糖尿病患者死亡率13.11%,远高于非糖尿病患者的死亡率6.15%(P<0.05)。前5位的死亡原因依次是恶性肿瘤(29.5%)、心血管疾病(25.7%)、肺部感染(14.2%)、肾功能衰竭(9.8%)和脑血管疾病(5.5%)。60~70岁组和70~80岁组首要死因是肿瘤,80~90岁组首要死因为心血管病,而90岁以上组肺部感染占第1位。高血压、高血脂、吸烟3个危险因素只有1个时心血管病死亡所占构成比为36.8%,而同时存在时心血管病死亡占所有死亡的比重增至50.0%。结论 糖尿病患者的死亡率明显高于非糖尿病患者。肿瘤和心血管疾病是老年糖尿病患者的主要死亡原因,但是在不同年龄组的重要性略有不同。心血管病死亡所占构成比与高血压、高血脂、吸烟等危险因素的聚集程度相关。

Analysis of the causes of hospital death in aged diabetics

Objective To understand the m ortality rate and main death causes of aged diabetics in hospital. Methods The clinical record of 183 aged diabetic patients, who were hospitalized and died be tween January, 1995 and December, 2002 in our hospital, were reviewed in compar ison with 293 non-diabetic aged patients hospitalized in the same period. Result s The mortality rate of the aged diabetics was 13.11%, far beyond that of the n on-diabetics. The main death causes of the diabetic patients were tumor (29.5%) , cardiovascular diseases (CVD, 25.7%), pulmonary infections (14.2%), renal dysf unction (9.8%) and cerebral vascular diseases (5.5%). Tumor was the main cause of death in the diabetic patients 60 to 80 years of age, and in those 80-90 yea rs old, CVD accounted for most of the deaths, whereas most patients over 90 year s old died of pulmonary in-fections. When only one of the 3 risk factors, namely hypertension, dyslipidemia and smoking, was present, CVD accounted for 36.8% o f all deaths; when all the 3 factors co-existed, CVD accounted for 50% of all de aths. Conclusions The mortality rate of aged diabetics is higher than that of t he non-diabetics. Tumor and CVD are the main causes of death, but the con-stitue nt ratio changes with age. The ratio of CVD in all death causes depends on the n umber of risk factors present, including hypertension, dyslipidemia and smoking .