Hermoni D, Nijim Y, Spenser T
Department of Family Medicine, Ben Gurion University of the Negev, Israel.
Br J Gen Pract. 1992 Dec;42(365):521-3.
The aims of this study were to examine mortality in one village in Israel and to determine which deaths could have been prevented by identifying those which were associated with avoidable factors or were caused by conditions which would have been amenable to preventive measures. The medical records of all 171 patients (91 males and 80 females) who died in the geographically defined population of 1800 during the 16 year period 1974-89 were reviewed. The mortality rate, adjusted for age, in the second eight year period (1982-89), was significantly lower for females (4.0 deaths per 1000 females per year) than for males (8.5) (P < 0.01). Downward trends in the birth rate, stillbirth rate and perinatal mortality rate were found, while there was an upward trend in both mean and median age at death. Of the 171 deaths, 36 (21%) were classified as being associated with a total of 44 factors which could be perceived as being avoidable. Twenty five of the avoidable factors were patient related and of these 17 were smoking (more than 20 cigarettes a day in patients aged less than 70 years who died of a smoking related disease). These findings confirm the need for continuous health education for patients. An audit of mortality in general practice is valuable and may contribute towards the prevention of some deaths.
本研究的目的是调查以色列一个村庄的死亡率，并通过识别那些与可避免因素相关或由可采取预防措施的疾病导致的死亡，来确定哪些死亡本可避免。回顾了1974年至1989年这16年间，在地理区域限定为1800人的人口中死亡的所有171名患者（91名男性和80名女性）的病历。在第二个八年期（1982 - 1989年），经年龄调整后的死亡率，女性（每年每1000名女性中有4.0人死亡）显著低于男性（8.5人）（P < 0.01）。发现出生率、死产率和围产期死亡率呈下降趋势，而平均死亡年龄和死亡年龄中位数呈上升趋势。在这171例死亡中，36例（21%）被归类为与总共44个可被视为可避免的因素相关。其中25个可避免因素与患者有关，在这些因素中，17个是吸烟（死于与吸烟相关疾病的70岁以下患者中，每天吸烟超过20支）。这些发现证实了对患者持续进行健康教育的必要性。对全科医疗中的死亡率进行审计是有价值的，可能有助于预防一些死亡。
