北京市某三级医院综合科老年共病住院患者临床特点分析  

Clinical Characteristics of Elderly Inpatients with Multimorbidity in Geriatric Department of a Tertiary Hospital in Beijing

作　　者：闫巍[1] 李瑞 王杰萍[1] 张洪波[1] 吴薇[1] 王斐 张洁[3] 张新焕[3] 朱钟慧 杜雪平[6] YAN Wei;LI Rui;WANG Jie-ping;ZHANG Hong-bo;WU Wei;WANG Fei;ZHANG Jie;ZHANG Xin-huan;ZHU Zhong-hui;DU Xue-ping(Department of General Practice,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Nephrology,Beijing First Hospital of Integrated Chinese and Western Medicine,Beijing 100026,China;Geriatric Department,Fuxing Hospital,Capital Medical University,Beijing 100038,China;School of Public Health,Capital Medical University,Beijing 100069,China;Beijing Key Laboratory of Environmental Toxicology,Capital Medical University,Beijing 100069,China;Yuetan Community Health Service Center of Fuxing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院全科医学科,北京市100038 [2]北京市第一中西医结合医院肾内科,100026 [3]首都医科大学附属复兴医院综合科,北京市100038 [4]首都医科大学公共卫生学院,北京市100069 [5]首都医科大学环境毒理学北京市重点实验室,北京市100069 [6]首都医科大学附属复兴医院月坛社区卫生服务中心,北京市100038

出　　处：《中国全科医学》2018年第14期1648-1656,共9页Chinese General Practice

基　　金：首都医科大学基础-临床科研合作基金(16JL59)

摘　　要：目的收集首都医科大学附属复兴医院老年共病住院患者的临床资料,分析其临床特征,为临床针对此类患者的医疗工作提供理论依据。方法选取2016-04-01至2017-03-31在首都医科大学附属复兴医院综合科住院的符合纳入标准的老年共病患者为研究对象。收集住院患者的病历资料。统计患者各种慢性病患病情况及其累及系统情况。比较不同性别和≥80岁、<80岁患者各种慢性病患病率。统计患者入院原因、感染发生率及感染部位。分别比较不同性别和<80岁、≥80岁患者感染发生率。比较发生感染和未发生感染患者住院期间各种急性并发症发生率及住院天数、住院日均费用。结果共纳入年龄≥60岁的非重复住院共病患者761例;男465例,女296例;<80岁患者125例,≥80岁患者636例。老年共病住院患者患慢性病数量为2~16个,其中31.4%(239/761)的患者患9种慢性病,19.3%(147/761)的患者患11种慢性病,18.0%(137/761)的患者患8种慢性病。老年共病住院患者慢性病累及系统数量为2~9个,其中27.9%(212/761)的患者累及5个系统,25.9%(197/761)的患者累及6个系统,12.2%(93/761)的患者累及4个系统。老年共病住院患者各种慢性病患病情况:74.9%(562/761)患高血压,73.9%(561/761)患高脂血症,66.8%(505/761)患脑梗死,48.1%(366/761)患冠心病,38.1%(290/761)患糖尿病。不同性别患者神经系统疾病中脑梗死和其他、呼吸系统疾病中慢性阻塞性肺疾病、泌尿系统疾病中前列腺增生、肌肉骨骼系统疾病中其他患病率比较,差异有统计学意义(P<0.05)。≥80岁患者冠心病、慢性心力衰竭、心律失常、消化性溃疡患病率高于<80岁患者(P<0.05)。18.7%(142/761)老年共病住院患者患有系统肿瘤,其中以消化系统肿瘤为主。41.3%(314/761)的患者由于急性感染入院。46.5%(354/761)的患者发生感染(40例为院内获得性感染),其中肺部感染占82.8%(293/354)。≥80岁患者感�Objective To analyze the clinical characteristics of elderly inpatients with multimorbidity from Geriatric Department,Fuxing Hospital,Capital Medical University based on the collected medical records,providing theoretical evidence for the diagnosis and treatment of such patients.Methods The enrolled elderly inpatients with multimorbidity were from Geriatric Department,Fuxing Hospital,Capital Medical University from April 1 st,2016 to March 31 st,2017.Based on the reviewing of their medical records,we analyzed the prevalence of chronic diseases and the involved systems,summarized the causes of hospitalization,incidence of infection and site of infection,and compared the prevalence of chronic diseases and incidence of infections by sex and age group（ ≥ 80 age group and 80 age group）.Moreover,the incidence of in-hospital acute complications,length of stay（LOS） and mean hospital costs per day between patients with infections during hospitalization and those without were compared.Results 761 inpatients（465 males and 296 females） aged 60 or over（125 patients 80 years old,and 636 patients ≥ 80 years old） with multimorbidity and non-repetitive hospitalization history were analyzed.The number of chronic diseases in the inpatients ranged from 2 to 16.31.4%（239/761）,19.3%（147/761）and 18.0%（137/761）had 9,11,8 chronic diseases,respectively.The number of systems involved by chronic diseases was 2-9 generally,in particular,the number of involved systems of 27.9%（212/761）,25.9%（197/761） and 12.2%（93/761） of the patients was 5,6,4,respectively.With regard to the prevalence of chronic diseases,74.9%（562/761）were found with hypertension,73.9%（561/761）with hyperlipidemia,66.8%（505/761） with cerebral infarction,48.1%（366/761） with coronary heart disease and 38.1%（290/761） with diabetes.Sex was not significantly associated with the prevalence of cerebral infarction and other nervous system diseases except cerebral infarction,neuropathy,dementia,and sequelae of cerebral he

关 键 词：慢性病 共病现象 老年人 住院病人 患病率 

分 类 号：R363[医药卫生—病理学]