Retrospective Analysis Of Hospitalized Death Cases During 2012?2018 In Cardiology Department Of Our Hospital

Background and objective: CVD is the leading cause of death in China,its morbidity and mortality continue to rise.In this article,through analyzing the clinical data of our hospital patient deaded in cardiovascular medicine,then to understand the cause of cardiology clinical characteristics,heart disease on admission,direct cause of death and the trend of change with the year.To further help and guide the overall management of cardiovascular disease and cardiology inpatients then reduce the risk of death.Methods: A total of 464 inpatients died in the department of cardiology of Shaanxi Provincial People's Hospital from January 2012 to December 2018.The clinical data and direct causes of death of hospitalized patients and the patients with CHD were analyzed retrospectively.Data included: general information of the patients(gender,age,smoking history),heart rate and blood pressure at admission,time of death(year,season,time period),heart disease at admission,concomitant diseases,laboratory indexes,ejection fraction,and direct cause of death.Results: 1.Features of inpatient died in department of cardiology:(1)more males than females,male: female=1.7:1;aged ? 60 years old with 390 patients(84.1%);.(2)the main seasons of death were spring and winter,with a total of 257 cases(55.4%).(3)328 patients with CHD(70.7%),72 patients(15.5%)with valvular disease,22 patients(4.7%)with cardiomyopathy,and there was no difference in the spectrum of heart disease on admission between 2012~2015 and 2016~2018(P>0.05).(4)hypertension was the main concomitant disease at admission,with a total of 261 cases(56.3%).(5)200 cases of HF(43.1%),135 cases of SCD(29.1%)and 52 cases of malignant arrhythmia(11.2%)were the top 3 direct causes of death,followed by infection,respiratory failure,gastrointestinal bleeding,asphyxia,accident,stroke and pulmonary embolism.2.Features of inpatient with CHD who died in hospital:(1)more males than females,male: female=1.56:1;aged ? 60 years old with 287 cases(87.5%).(2)a total of 254 cases(77.4%)were AMI.(3)patients with hypertension,diabetes and atrial fibrillation showed no differences in gender,age and year of death(P>0.05).The proportion of COPD in 2016~2018 was lower than that in 2012~2015(P<0.05).(4)female patients and patients aged <60 years old were more likely to die due to malignant arrhythmia(P<0.05).The rate of death due to HF decreased with year(P<0.05),while the rate of SCD increased(P<0.05).(5)analysis of case data of the top 3 direct causes of death suggested that age,DBP,Hb,SCr,BNP,and COPD were associated with different causes of death(P<0.05).The age of malignant arrhythmia group was lower than that of other groups(P<0.05).Hb of the HF group were lower than those of the other groups(P<0.05),while BNP was higher than that of the SCD group(P<0.05).Conclusions:1.The season of death of inpatients in the department of cardiology is mainly in spring and winter,and hypertension is the most common accompanying disease.The comprehensive management and effective control of hypertension and the high incidence season should be strengthened,so as to reduce the risk of death of inpatients in the department of cardiology.2.CHD,especially AMI,is the main cardiac disease of hospitalized patients in the department of cardiology.To prevent CHD occurrence and reduce the death of AMI still is one of the important tasks of clinical work of cardiologists.3.The direct causes of death were HF,SCD,and malignant arrhythmias.And the rate of SCD has an increasing trend with years.Age,Hb and BNP are different among the three direct causes of death,and targeted monitoring and intervention should be strengthened in combination with different patient conditions.