泰国南部因哮喘和慢性阻塞性肺疾病加重而住院的成人的院内死亡率和住院结果(2017-2021年):基于人口的研究  

In-hospital Mortality and Hospital Outcomes among Adults Hospitalized for Exacerbations of Asthma and COPD in Southern Thailand(2017-2021):A Population-Based Study

作　　者：Narongwit Nakwan Kanittha Suansan Narongwit Nakwan;Kanittha Suansan(Division of Pulmonology,Department of Medicine,Hat Yai Medical Education Center,Hat Yai Hospital,Songkhla,Thailand;National Heath Security Office(NHSO),Region 12,Thailand)

机构地区：[1]泰国宋卡府合艾医院合艾医学教育中心呼吸内科 [2]泰国国家卫生安全办公室(NHSO)第12区

出　　处：《Chinese Medical Sciences Journal》2023年第3期228-234,I0006,共8页中国医学科学杂志（英文版）

摘　　要：背景泰国因哮喘和慢性阻塞性肺疾病(COPD)恶化而住院的情况时有发生。住院治疗结果的全国性趋势对于医疗保健系统内预防策略的规划至关重要。本文研究了泰国南部因哮喘和COPD加重而住院的成人的住院结果的时间趋势,包括死亡率、住院时间(LOS)和报销费用。方法利用泰国南部国家卫生安全办公室提供的数据,对因哮喘和COPD加重而住院的成人进行了一项基于人群的回顾性研究。对2017年至2021年期间分别因哮喘和COPD住院的19,459例患者和66,457患者进行了基线人口统计学和住院结果评估。结果随着时间的推移,因哮喘和COPD加重而住院的人数显著减少,尤其是在2020/2021年。从2017年到2021年,哮喘的院内死亡率从每1,000例住院患者中有3.2例死亡上升到3.7例(P<0.05)。另一方面,COPD的入院死亡率在2017年至2020年期间从每1000例住院患者20.3例死亡降至16.4例,但随后在2021年又增至21.8例(P<0.05)。死亡率上升的主要原因是年龄的增长。不过,在研究期间,哮喘和COPD的平均住院时间都略有缩短。哮喘和COPD每次住院的总费用显著增加,2020/2021年的增幅尤为明显。结论2017-2021年间,泰国哮喘和COPD加重继续在院内死亡率和报销费用中占据重要地位,但住院人数总体有所减少,住院时间也略有波动。Background Hospitalizations for asthma and chronic obstructive pulmonary disease(COPD)exacerbations frequently occur in Thailand.National trends in hospital outcomes are essential for planning preventive strategies within the healthcare system.We examined temporal trends in in-hospital outcomes,including mortality rate,length of stay(LOS),and expenses for reimbursement in adults hospitalized for asthma and COPD exacerbations in southern Thailand.Methods A retrospective,population-based study on adults hospitalized for exacerbations of asthma and COPD was carried out using data from the National Health Security Office in southern Thailand.Baseline demographic and in-hospital outcome assessments were conducted on 19,459 and 66,457 hospitalizations for asthma and COPD,respectively,between 2017 and 2021.Results Significant reductions in hospital admissions for exacerbations of asthma and COPD were observed over time,particularly in 2020/2021.From 2017 to 2021,the in-hospital mortality rate for asthma rose from 3.2 to 3.7 deaths per 1,000 admissions(P<0.05).The rates for COPD admissions,on the other hand,reduced from 20.3 to 16.4 deaths per 1,000 admissions between 2017 and 2020,but subsequently increased to 21.8 in 2021(P<0.05).The prominent contributor to the higher mortality rate was found to be increasing age.Nonetheless,the average LOS for both asthma and COPD decreased slightly over the study period.The total expenses for reimbursing exacerbations of asthma and COPD per hospitalisation have risen significantly each year,with a particularly notable increase in 2020/2021.Conclusion During 2017-2021,exacerbations of asthma and COPD in Thailand continued to account for significant in-hospital mortality rates and reimbursement expenses,despite the overall decrease in hospitalizations and slight fluctuations in the LOS.

关 键 词：住院 死亡率 加重 泰国 

分 类 号：R562.25[医药卫生—呼吸系统] R563.9[医药卫生—内科学] R197.3[医药卫生—临床医学]