尼日利亚西南部一家三级医疗机构急诊科接收的死亡患者的人口统计学特征及死因

Demographic characteristics and causes of death for persons brought in dead to emergency department of a Tertiary Health Facility in South-West Nigeria.

作者信息

Adegoke Oluseyi, Ajuluchukwu Janet Ngozi

机构信息

Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.

出版信息

Niger Postgrad Med J. 2019 Jan-Mar;26(1):45-52. doi: 10.4103/npmj.npmj_170_18.

DOI:10.4103/npmj.npmj_170_18

PMID:30860199

Abstract

INTRODUCTION

Identifying the demographic characteristics and causes of death in persons 'brought-in-dead' (BID) will inform possible strategies for the prevention of their occurrence.

OBJECTIVE

To characterise the demography as well as document the autopsy-determined underlying and immediate causes of death in BID cases presenting to the emergency department (ED) of a tertiary health facility.

METHODS

This is a 5-year retrospective descriptive study of 253 autopsied-BID cases. Data were obtained from ED 'death-register' and the hospital 'autopsy-register'. The underlying and immediate causes of death were classified and analysed across the age groups of 21-40, 41-60 and >60 years.

RESULTS

The age of the cases ranged from 22 to 101 years with a median of 56.0 (38-72) years. Almost half [110(43.5%)] of the cases were in the age-group >60 years. The male-to-female ratio was 1.04:1, and their ages were comparable. Non-communicable diseases accounted for 216 (85.4%) of the underlying causes of death. Three major specialities contributing to death were medicine 117 (46.2%), oncology 45 (17.0%) and surgery/trauma 42 (16.6%). Specialties of medicine and surgery/trauma were predominantly in age groups >60 years (60.0%) (P ≤ 0.0001) and 20-40 years (31.5%) (P = 0.0001), respectively. The chief underlying causes of death in the specialities of medicine, oncology and surgery/trauma were cardiovascular diseases (61 [52.1%]), breast cancer (11 [24.4%]) and road traffic accidents (31 [73.8%]), respectively. Overall immediate causes of death included heart failure (21.3%), unspecified circulatory collapse (17.0%), central nervous system pathologies (16.6%) and haemorrhagic shock (10.7%). Heart failure (33.6% [37/110]) and haemorrhagic shock (28.8% [21/73]) were the most common immediate causes of death in the >60 years' and 20-40 years' age groups, respectively.

CONCLUSION

Non-communicable diseases are the leading causes of death in persons 'BID'. Deaths from medical conditions, especially heart failure, occurred mainly in the elderly. Deaths from trauma and haemorrhage occurred predominantly in the young.

摘要

引言

确定“送来即死亡”（BID）者的人口统计学特征和死因，将为预防此类情况发生的可能策略提供依据。

目的

描述三级医疗机构急诊科收治的BID病例的人口统计学特征，并记录尸检确定的潜在死因和直接死因。

方法

这是一项对253例经尸检的BID病例进行的为期5年的回顾性描述性研究。数据取自急诊科“死亡登记册”和医院“尸检登记册”。对21 - 40岁、41 - 60岁和60岁以上年龄组的潜在死因和直接死因进行分类和分析。

结果

病例年龄范围为22至101岁，中位数为56.0（38 - 72）岁。几乎一半[110（43.5%）]的病例年龄在60岁以上。男女比例为1.04:1，年龄相当。非传染性疾病占潜在死因的216例（85.4%）。导致死亡的三个主要专科是内科117例（46.2%）、肿瘤学45例（17.0%）和外科/创伤科42例（16.6%）。内科和外科/创伤科主要分别见于60岁以上年龄组（60.0%）（P≤0.0001）和20 - 40岁年龄组（31.5%）（P = 0.0001）。内科、肿瘤学和外科/创伤科的主要潜在死因分别是心血管疾病（6[52.1%]）、乳腺癌（11[24.4%]）和道路交通事故（31[73.8%]）。总体直接死因包括心力衰竭（21.3%）、未明确的循环衰竭（17.0%）、中枢神经系统病变（16.6%）和失血性休克（10.7%）。心力衰竭（33.6%[37/110]）和失血性休克（28.8%[21/73]）分别是60岁以上和20 - 40岁年龄组最常见的直接死因。