《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]
卷:
第25卷
期数:
2018年03期
页码:
20-23
栏目:
医疗质量
出版日期:
2018-03-28
- 作者:
-
王妮 黄艳群 费晓璐 魏岚 陈卉
-
首都医科大学生物医学工程学院
- 关键词:
-
住院病案首页; Charlson合并症; 脑卒中; 死亡
- Keywords:
-
Home Page of Medical Records; Charlson Comorbidity; Stroke; Mortality
- DOI:
-
10.13912/j.cnki.chqm.2018.25.3.08
- 摘要:
-
目的利用Charlson 合并症指数（CCI）评价合并症程度，并分析其与脑卒中患者院内死亡的关系。方法回顾性分析某三甲医院2014年-2016年9 174名脑卒中患者的住院病案首页，利用相关字段统计患者的Charlson合并症种类和数量，并计算相应的CCI分值及校正年龄的aCCI分值，比较不同合并症程度的脑卒中患者院内死亡率的差异，利用Logistic回归分析探讨Charlson合并症与脑卒中患者院内死亡之间的关系。结果16种Charlson合并症中，合并中重度肾病的患者最多（44.8%），其次为糖尿病（不伴合并症）（27.3%）和周围血管疾病（8.5%）。无/轻度合并症患者、中度合并症患者、严重合并症患者的院内死亡率分别为1.07%、1.40%和2.23%（P=0.001）。充血性心力衰竭、消化性溃疡、糖尿病以及恶性肿瘤（含白血病和淋巴癌）是脑卒中患者院内死亡的影响因素。未经年龄校正的CCI、校正年龄的aCCI是脑卒中患者院内死亡的影响因素。结论利用CCI评价不同合并症程度具有一定可行性。在分析脑卒中患者的院内死亡率时，适宜用校正年龄的aCCI分值。
- Abstract:
-
ObjectiveTo assess the degree of comorbidities by using the Charlson Comorbidity Index (CCI) and analyze its relationship with in-hospital death among stroke patients.MethodsThe home page of medical records of 9174 inpatients with stroke in 2014-2016 was retrospectively analyzed. The type and number of Charlson comorbidities of the patients were analyzed, and the CCI score and the aCCI score were calculated using the relevant variables. And the differences in in-hospital mortality in stroke patients with comorbidities of different degree were analyzed by logistic regression analysis.ResultsAmong the 16 Charlson comorbidities, the patients with moderate to severe kidney disease were the most (44.8%), followed by diabetes (no complication) (27.3%) and peripheral vascular disease (8.5%). The in-hospital mortality rates were 1.07%, 1.40%, and 2.23% (P=0.001) for patients with or without mild comorbidities, moderate comorbidities, and severe comorbidities, respectively. Congestive heart failure, peptic ulcer, diabetes, and malignancy (including leukemia and lymphoma) were the factors influencing in-hospital death in stroke patients. Unadjusted CCI and age-adjusted aCCI were the influential factors of in-hospital death in stroke patients.Conclusion It is feasible to evaluate the degree of different comorbidities with CCI. When the in-hospital mortality of stroke patients is analyzed, the age-adjusted aCCI score is recommended.
更新日期/Last Update:
2018-03-28
