摘要
目的研究70岁及以上老年住院死亡患者的疾病构成、死亡年龄和季节分布、死亡原因及临终救治方式,为老年人群健康管理和疾病防治提供借鉴。方法回顾性分析2014年1月至2019年1月首都医科大学附属北京天坛医院综合内科77例年龄≥70岁死亡病例的临床资料。结果 77例死亡患者中,存在3种及以上内科慢性疾病者占74.0%;死亡人数最多的年龄段为80~89岁,共43例(55.8%);死亡人数最多的季节为冬、春季,分别为24例(31.1%)和21例(27.3%);前3位死因依次为肺部感染(48.1%)、恶性肿瘤(28.5%)和心血管疾病(14.2%)。进一步分析显示,80岁以下患者的首位死因为恶性肿瘤(71.4%),而80岁及以上患者的首位死因为肺部感染(57.1%)。仅13.0%的患者临终选择有创抢救,87.0%的患者放弃有创救治而选择临终关怀。结论在70岁及以上综合内科老年住院死亡患者中,多病共存比较常见,肺部感染和恶性肿瘤是最常见的死因,80岁为界的上下不同年龄段的老年患者的首位死因不同,临终放弃有创救治比较普遍。
Objective To provide reference of health management and disease prevention for elderly population by study the disease composition, age and season distribution of death, causes of death and treatment methods at the life end of elderly hospitalized deaths aged 70 years and over. Method A retrospective analysis was used to summarize and analyze 77 died patients over 70 years old in the Department of General Internal Medicine of Beijing Tiantan Hospital. Result Among the 77 died cases, 74.0% of the patients had three or more internal chronic disease, the highest mortality rate group was 80~89 years old(43 cases, 55.8%), the seasons with the highest mortality rate were winter(24 cases, 31.1%) and spring(21 cases, 27.3%), top three causes of death included pulmonary infection(48.1%), malignant tumors(28.5%) and cardiovascular diseases(14.2%). Further analysis showed that malignant tumors were the first cause of death in patients under 80 years old(71.4%) and pulmonary infection was the first cause of death in patients aged 80 and over(57.1%). At the end of life, only 13.0% of the old inpatients chose invasive rescue approach, whereas 87.0% of the patients gave up the invasive treatment and chose to hospice care. Conclusion Among the elderly hospitalized death patients aged 70 and over in Department of General Internal Medicine, multiple diseases coexist more frequently, pulmonary infection and malignant tumors are the most common causes of death, the first cause of death is different in different age groups, it is common to give up invasive rescue at the end of life.
作者
刘丽
程晓玲
李婧婧
张铁梅
杜凤和
张巍
LIU Li;CHENG Xiao-ling;LI Jing-jing;ZHANG Tie-mei;DU Feng-he;ZHANG Wei(Department of General Internal Medicine,Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;Department of Neurology, Center for Cognitive Neurology,Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China)
出处
《中国医刊》
CAS
2019年第10期1084-1086,共3页
Chinese Journal of Medicine
基金
国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2016YFC1306300、2016YFC1306000)
国家自然科学基金面上项目(81571229、81071015、30770745)
关键词
老年人
70岁及以上
死亡分析
临终救治方式
Aged,70 years and over
Death analysis
Treatment methods at the end of life
