Analysis Of Deaths In The First Department Of Respiratory And Critical Care In A Tertiary Hospital From 2016 To 2019

ObjectiveRetrospective and descriptive analyze the clinical data of death cases in the Department of Respiratory and Critical Care,Shaanxi Provincial People's Hospital from 2016 to 2019,understand the general clinical characteristics of death patients,explore the root and direct causes of death,analyze relevant influencing factors,and provide guidance value for the clinical,Reduce mortality and prolong patient survival.MethodCollected cases of death from the first page of the Department of Respiratory and Critical Care Medical Records,Shaanxi Provincial People's Hospital from January 1,2016 to December 31,2019,and analyzed the general information,survival time,clinical characteristics,death Causes and other clinical data.Summarize the results of various examinations,basic diseases,comorbidities,and invasive procedures of death cases.Statistical analysis was performed on the above data by SPSS23.0 statistical software.The measurement data obeyed the normal distribution and expressed as x±s.The comparison between groups was performed using the t test or z test.The median and interquartile range were not used for the normal distribution.Means.Count data were expressed as percentages(%).Comparisons between groups were performed using the ?2 test.P <0.05 was considered statistically significant.Results1.From 2016 to 2019,a total of 242 cases of death were discharged from the first page of the Department of Respiratory and Critical Care Unit Medical Records of Shaanxi Provincial People's Hospital.According to the inclusion and exclusion criteria,a total of 203 final statistical samples were obtained,including 132 males and females.71 cases with a male to female ratio of 1.85: 1.Among the 203 patients,the age ranged from 46 to 94 years,with an average age of 78.00 ± 9.754 years,which did not meet the normal distribution.The average age of male patients was 78.18 ± 9.552 years,and the average age of female patients was 77.67 ± 10.179 years.2.Of the 203 deaths,the month with the highest number of deaths was January(27,13.3%),and the month with the lowest number of deaths was October(8,3.9%).The shortest hospital stay was 1 day and the longest was 97 days,with an average of 10.87 ± 10.32 days.The highest proportion of hospital stays was 5 days(18 cases,8.9%).The highest number of deaths at 24 time points per day was 13 o'clock(23 cases,11.3%),followed by 14 o'clock(18 cases,8.8%),21 o'clock(16 cases,7.8%);the smallest was 24 o'clock.Deaths.There was no statistical difference in age and gender between the season and time of death(P>0.05).3.The top three patients in the primary disease spectrum of 3.203 deaths were 113(55.66%)with severe pneumonia,35 with AECOPD(17.24%),and 31 with bronchial lung cancer(15.27%).According to the original medical records of the dead patients,the direct causes of death were divided into 8 categories,among which infection,septic shock,and multiple organ dysfunction were the majority.4.Among 113 patients with primary pneumonia who died of severe disease,105 cases were female ?65 years old and 8 cases were <65 years old.The previous medical history and clinical characteristics of two groups were compared.,WBC ?10 × 109 / L,BNP ?100ng / L,Lac?2mmol/L,Na ?145mmol / L were significantly different between the two groups(P <0.05).5.Among the 203 dead patients,the top three complications of male patients were hypertension(93.18%),chronic cardiac insufficiency(84.84%),and chronic kidney disease(34.09%).The proportion of these three types of complications in female patients was lower than that in men.6.Elderly deaths account for 70.93% of the total number of deaths,and more than 80% of elderly patients have heart failure,renal insufficiency,history of stroke,long-term bed rest and malnutrition,and more than 70% of elderly patients have a long history of constipation.7.The 203 death patients were divided into two groups according to the presence or absence of mechanical ventilation before death.Comparing the average length of hospital stay between the two groups,the results showed significant difference(P<0.05).Conclusions1.From 2016 to 2019,there were more males than females in the Department of Respiratory and Critical Illness of Shaanxi Provincial People's Hospital,mainly elderly patients.Among them,144 were elderly patients,and there were many clinical complications.2.The number of death cases in one department of respiratory and critical illness is mostly in winter and spring.There is no obvious correlation between the age and gender of the season and time of death.3.The top three in the primary disease spectrum of death cases are severe pneumonia,AECOPD,and bronchial lung cancer.The direct causes of death are complex,mostly respiratory failure,septic shock,and multiple organ dysfunction,including many complications and complications Heavy.4.Disturbance of consciousness,body temperature ?38 ° C,WBC ?10 × 109 / L,BNP ?100ng / L,Lac?2mmol/L,Na + ?145mmol / L were significantly different between the two groups in severe pneumonia(P <0.05).5.The use of mechanical ventilation before death has significant effect on the average length of hospital stay.