我院2000-2010年住院慢性阻塞性肺疾病患者死亡原因分析

目的 回顾性研究住院慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD) 死亡患者人群分布特征、死亡原因和相对危险度.方法 对2000 年1 月-2010 年3 月解放军总医院、北京协和医院及卫生部北京医院的住院病案数据库进行回顾性调查,共入选病例4 960 例,院内死亡患者361 例( 占7.28%),男性221 例,女性140 例,平均年龄男性(67.6±11.7) 岁,女性(72.2±10.4) 岁,平均住院(25.39±7.58)d,其中男性平均住院(27±7.9)d,女性(20±6.7)d.结果 1) 年龄、COPD、呼吸衰竭、慢性肾功能衰竭、糖尿病和血糖水平升高均与COPD 患者院内死亡呈正相关;2) 危险度排序为:呼吸衰竭19.94%、慢性肾功能衰竭14.40%、急性肾功能衰竭12.74%、肺源性心脏病11.36%、心力衰竭10.80%、急性心肌梗死9.42%、恶性肿瘤5.54%、心室扑动/ 心室颤动/ 室性心动过速5.26%、脑梗死4.98%、肺栓塞3.05%、脑出血2.49%.结论 COPD 死亡原因除呼吸系统外,其他系统疾病也是导致住院COPD 患者死亡的主要原因,所以,全身系统治疗和器官保护对COPD 患者的预后十分重要.

Causes of death of inpatients with chronic obstructive pulmonary disease from 2000 to 2010 in our hospital

Objective To retrospectively analyze the distribution of dead inpatients with chronic obstructive pulmonary disease(COPD),causes of their death,and relative risk factors for death.Methods A total of 4 960 COPD patients admitted to Chinese PLA General Hospital,Beijing Union Medical College Hospital and Beijing Hospital from January 2000 to March 2010,covered in medical record database,were retrospectively analyzed in this study.Of these patients,361(221 males and 140 females) were dead cases(7.28%),their mean age was(67.6±11.70) years and(72.2±10.40) years,their mean hospital stay time was(25.39±7.58)d and(27±7.9)d of males and(20±6.7)d of females.Results Age,COPD,respiratory failure,chronic renal function failure,diabetes and elevated blood sugar level were positively correlated with the death of COPD inpatients.The most important risk factor for death of COPD patients was respiratory failure(19.94%),followed by chronic renal function failure(14.40%),acute renal function failure(12.74%),pulmonary heart disease(11.36%),cardiac failure(10.80%),acute myocardial infarction(9.42%),malignant tumor(5.54%),ventricular flutter/ventricular fibrillation/ventricular tachycardia(5.26%),cerebral infarction(4.98%),pulmonary embolism(3.05%),and cerebral hemorrhage(2.49%).Conclusion Diseases of respiratory system and other systems are the main cause of death of COPD patients,thus systemic treatment and protection of organs play an important role in the prognosis of COPD patients.