2型糖尿病与非2型糖尿病急诊死亡患者病例资料分析

来源:用户上传      作者:赵晓丽 刘冰 马莹暄 程洁 张春燕 祝振忠

　　[摘要]目的分析并比较2型糖尿病与非2型糖尿病急诊死亡患者的病例Y料分布特点，为制订相关疾病的预防措施提供依据。方法对北京大学首钢医院急诊科2014年1月至2021年12月记录完整的1799例急诊死亡病案进行回顾分析，根据是否患糖尿病分为糖尿病组和非糖尿病组，对两组的年龄分布、性别构成、死亡原因、季节及月份分布进行比较分析。结果共收集1799例急诊死亡患者，其中糖尿病组557例占31%，平均年龄（77.20±11.46）岁，非糖尿病组1242例占69%，平均年龄（76.56±15.37）岁，总体年龄分布差异无统计学意义（ P >0.05），但两组死亡人数随着年龄增长而明显增多，60～89岁糖尿病组死亡率明显高于非糖尿病组（ P <0.05），≥90岁糖尿病组死亡率明显低于非糖尿病组（ P <0.05）。糖尿病组男女构成比为0.96∶1，非糖尿病组为1.22∶1，差异有统计学意义（ P <0.05）。所有死亡患者中，死因前4位依次为呼吸系统疾病、猝死、肿瘤、循环系统疾病，比较两组患者常见死因，糖尿病组较非糖尿病组循环系统疾病、肾衰竭更常见。四季分布中冬季死亡人数最多，夏季死亡人数最少，总体死亡分布差异有统计学意义（ P <0.05）;糖尿病组与非糖尿病组分布特点与总体的四季分布特点相似，但糖尿病组四季分布差异无统计学意义（ P >0.05）。死亡患者按照12个月分组，糖尿病组12月死亡人数最多，非糖尿病组1月死亡人数最多。结论急诊死亡患者中糖尿病组老年患者死亡率更高，且女性高于男性，死亡人数具有季节及月份高峰特点。因此，在今后的糖尿病防控工作中，应加强对老年人群及女性糖尿病患者的健康宣教及慢病管理，合理配置急诊医疗资源。
　　[关键词]急诊;死亡病例;病因;2型糖尿病
　　[中图分类号] R587. [文献标识码] A [文章编号]2095-0616（2022）14-0102-05
　　Analysis on the data of dead cases with T2DM and non-T2DM in the emergency department
　　ZHAO Xiaoli LIU Bing MA Yingxuan CHENG Jie ZHANG Chunyan1ZHU Zhenzhong
　　1.Department of Emergency Medicine， Shougang Hospital of Peking University， Beijing 100144， China;2. Department of Medical Records， Shougang Hospital of Peking University， Beijing 100144， China
　　[Abstract] Objective To analyze and compare the distribution characteristics of the data of dead cases with type diabetes mellitus （T2DM） and non-T2DM in the emergency department， so as to provide a basis for developing preventive measures for related diseases. Methods A total of 1799 dead cases with complete records in the Department of Emergency Medicine in Shougang Hospital of Peking University from January 2014 to December 202 were retrospectively analyzed. They were divided into the T2DM group and the non- T2DM group according to whether they suffered from T2DM. The age distribution， gender composition， cause of death， and seasonal and monthly distributions of the two groups were analytically compared. Results A total of 1799 emergency deaths were collected， including 557 cases （31%） in the diabetic group with an average age of （77.20±11.46） years， and 124 cases （69%） in the non-diabetic group with an average age of （76.56±15.37） years. There was no statistical significance in overall age distribution （P >0.05）. However， the number of deaths in both groups increased significantly with age， and the mortality rate in cases aged 60-89 years in the T2DM group was significantly higher than that in the non-T2DM group （P <0.05）， while the mortality rate in cases aged ≥90 years in the T2DM group was significantly lower than that in the non-T2DM group （P <0.05）. Themale-to-female ratio was 0.96∶ in the T2DM group and 1.22∶ in the non-T2DM group，with a statistical difference （P <0.05）. The top4 causes of death for all of these dead cases were respiratory diseases， sudden death， tumors， and circulatory diseases in order， and common causes of death such as circulatory diseases and renal failure were more common in the T2DM group than in the non-T2DM group. In terms of seasonal distribution， the number of deaths was the highest in winter and the lowest in summer， with a statistical difference in the overall distribution of deaths （P <0.05）. The distribution characteristics of the T2DM group and the non-T2DM group were similar to the overall seasonal distribution characteristics， but the four seasons distribution differences of T2DM group were not statistically significant （P >0.05）. In terms of monthly distribution （with dead cases grouped by months）， the highest number of deaths in the T2DM group occurred in December and that in the non-T2DM group occurred in January. Conclusion Among deaths in the emergency department， the mortality rate is higher in elderly cases in the T2DM group and is higher in women than in men， and the number of deaths shows seasonal and monthly peak characteristics. Therefore， it is necessary to strengthen health education and chronic disease management for the elderly population and female diabetic patients in the future prevention and control of diabetes mellitus， and reasonably allocate emergency medical resources.

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