山西省急性心肌梗塞患者院内死亡影响因素的多水平模型分析  

Analysis of Factors Influencing Mortality of Inpatients with AMI Based on Multi-Level Logistic Model in Shanxi Province

作　　者：程兆辉 贺知菲 陶红兵[3] 许小兰[1] 余中心[1] 吴开明[1] Cheng Zhaohui(Chongqing Health Information Center,Chongqing,401120)

机构地区：[1]重庆市卫生信息中心,重庆401120 [2]西南政法大学政治与公共管理学院,重庆401120 [3]华中科技大学同济医学院医药卫生管理学院,武汉430030

出　　处：《医学与社会》2018年第9期42-44,62,共4页Medicine and Society

摘　　要：目的:研究急性心肌梗塞(AMI)患者院内死亡的影响因素,为降低AMI患者院内死亡风险提供依据。方法:收集山西省31家三级综合医院AMI患者住院病历首页数据,运用χ2分析对AMI患者院内死亡相关因素进行单因素检验,使用两水平Logistic回归模型分析患者院内死亡影响因素。结果:女性、高龄、危急重症、较高的合并症CCI评分是AMI患者院内死亡的主要危险因素;每百张床位护士数的增加以及纳入临床路径和单病种管理是主要保护因素。结论:应对AMI高危死亡风险患者重点关注并及时采取针对性保护措施;AMI患者的院内死亡风险存在不可忽略的医院效应,应加强对医务人员的培训,提高AMI临床治疗水平。Objective： To explore influencing factors which affected in-hospital mortality of AMI.Methods： AMI patients＇ medical records information in 31 tertiary general hospitals in Shanxi Province were selected. Chi-square test was used in univariate analysis, and two-level logistie model was used to analyze the risk fhctors. Results： The scores of female, older age, critical illness and high CCI are main risk factors and the number of nurses per 100 beds and the inclusion of clinical pathways and single disease management are main protective factors for AMI in-hospital mortality. Conclusion： The AMI mortality related to individual factors, and the hospital effect also can not be ignored. We should take specific measures to reduce the in-hospital motality risk of AMI, strengthen medical staff training to improve the medical technology and the standardization of clinical treatment.

关 键 词：急性心肌梗塞 两水平logistic模型 院内死亡 影响因素 山西 

分 类 号：R195.4[医药卫生—卫生统计学]