某三甲综合医院314例手术患者住院死亡病例分析  

Analysis of 314 death of surgical patients in a Tertiary Hospital

作　　者：胡珍珍 王振宇[1] 姚静[1] 李大勇 Hu Zhenzhen;Wang Zhenyu;Yao Jing;Li Dayong(The Second People's Hospital of Wuhu City,Wuhu 241000,Anhui Province,China)

机构地区：[1]华东师范大学附属芜湖医院(芜湖市第二人民医院),安徽省芜湖市241000

出　　处：《中国病案》2025年第1期80-83,共4页Chinese Medical Record

摘　　要：目的了解某院手术患者住院死亡病例特点及影响因素,为医院加强手术质量管理提供依据。方法从某院病案统计系统检索2021年1月1日-2023年12月31日出院患者住院病案首页手术操作栏目类型为“手术”或“介入手术”且离院方式为“5.死亡”病例共计314例,对术后死亡病例进行回顾性分析。结果3年间手术患者出院人次为58696,死亡314人,手术患者住院死亡率为0.53%;手术患者住院死亡率男性为0.86%,高于女性的0.3%,≥80岁年龄段死亡率最高为2.51%,急诊死亡率2.05%高于门诊(择期)的0.19%,4级手术死亡率1.31%,高于其他级别手术的0.34%;死因构成排名前3位的是循环系统疾病、损伤和中毒及外因的某些其他后果、肿瘤;绝大多数患者死亡发生在术后48小时以后;术后死亡患者主要集中在神经外科、普外科、介入科。结论高龄、男性、急诊、4级手术、非计划转ICU等均为术后死亡的高风险因素,也是医院手术质量管理的重中之重。Objectives This study aims to understand the characteristics and imaging factors of postoperative death records of inpatients in a hospital,so as to provide a basis for strengthening the management of surgical quality in the hospital.Methods A total of 314 cases with the code type of"operation"or"intervention operation"and the mode of leaving hospital from January 1,2021 to December 31,2023 were retrieved by the medical record statistics system,and the postoperative death cases were analyzed retrospectively.Results Over three years,58,696 people underwent surgery,with 314 fatalities,resulting in a mortality rate of 0.53%among surgical patients.The in-hospital mortality rate of surgical patients was 0.86%for males,higher than 0.30%for females.The mortality rate was highest at 2.51%in the age group≥80 years old.The emergency mortality rate was 2.05%,higher than 0.19%for outpatient(elective)surgery.The mortality rate of grade 4 surgery was 1.31%,higher than 0.34%for other grades of surgery.The top three causes of death were circulatory system diseases,injuries and poisoning,som other consequences of external causes and tumors.Most patients died 48 hours after operation.Postoperative death patients were mainly concentrated in neurosurgery,general surgery and international department.Conclusions Old age,male,emergency,level 4 surgery,and unplanned transfer to the ICU are all high-risk factors for postoperative mortality and are also the top priority of hospital surgical quality management.

关 键 词：医疗质量 手术质量 住院手术患者 术后死亡 死亡率 

分 类 号：R197.323[医药卫生—卫生事业管理]