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2018 年越南一级和二级医院重症监护病房患者入院和住院死亡率的原因:一项多中心回顾性研究。

Causes of admissions and in-hospital mortality among patients admitted to critical care units in primary and secondary hospitals in Vietnam in 2018: a multicentre retrospective study.

机构信息

Department of Infectious Diseases, Hanoi Medical University, Hanoi, Viet Nam

Department of Infectious Diseases, Hanoi Medical University, Hanoi, Viet Nam.

出版信息

BMJ Open. 2022 Jun 13;12(6):e061638. doi: 10.1136/bmjopen-2022-061638.

Abstract

OBJECTIVE

The goal of this study was to describe the burden of disease and in-hospital mortality among patients admitted to the critical care units (CCUs) in Vietnam.

DESIGN

Retrospective study.

SETTING

The whole 1-year data of admissions to CCUs were collected from 34 hospitals from January to December 2018.

PARTICIPANTS

A total of 44 013 episodes of admission to CCUs were analysed.

PRIMARY OUTCOME

We used International Classification of Diseases-11 codes to assess the primary diagnosis associated with admissions and in-hospitals mortality. Years of life lost (YLL) measure was further used to estimate the burden of disease.

RESULTS

The 0-5 years and ≥70 years age groups accounted for 14.8% (6508/44 013) and 26.1% (11 480/44 013) of all admissions, respectively. The most common diagnoses were diseases of the respiratory system (27.8% or 12 255/44 013), followed by unclassified symptoms, signs or clinical findings (13% or 5712/44 013), and diseases of the circulatory system (12.2% or 5380/44 013). Among 28 311 patients with available outcome data, 1681 individuals (5.9%) died during the hospitalisation. The in-hospital mortality rate increased with age, from 2.8% (86/3105) in under 5 years old age group to 23.1% (297/1288) in over 90-year age group. Diseases of the respiratory system was the leading causes of death in term of number of deaths (21.8% or 367/1681 of all deaths). Diagnosis of sepsis was associated with the highest in-hospital mortality (36.8%). The overall YLL under the age of 75 were 1287 per 1000 patients.

CONCLUSIONS

CCUs in Vietnam faced wide differences in the burden of diseases. Sufficient infrastructure and adequate multidisciplinary training are essential to ensure the appropriate response to the current needs of population.

摘要

目的

本研究旨在描述越南重症监护病房(CCU)入院患者的疾病负担和院内死亡率。

设计

回顾性研究。

地点

2018 年 1 月至 12 月,从 34 家医院收集了 CCU 住院患者的全年数据。

参与者

共分析了 44013 例 CCU 住院患者。

主要结局

我们使用国际疾病分类-11 代码评估与入院和院内死亡相关的主要诊断。进一步使用寿命损失年(YLL)来衡量疾病负担。

结果

0-5 岁和≥70 岁年龄组分别占所有住院患者的 14.8%(6508/44013)和 26.1%(11480/44013)。最常见的诊断是呼吸系统疾病(27.8%,12255/44013),其次是未分类的症状、体征或临床发现(13%,5712/44013),以及循环系统疾病(12.2%,5380/44013)。在 28311 例有可用结局数据的患者中,1681 人(5.9%)在住院期间死亡。住院死亡率随年龄增长而增加,从 5 岁以下年龄组的 2.8%(86/3105)增加到 90 岁以上年龄组的 23.1%(297/1288)。呼吸系统疾病是死亡人数最多的主要死因(所有死亡人数的 21.8%,即 1681 人中有 367 人)。败血症的诊断与最高的院内死亡率相关(36.8%)。75 岁以下人群的总体 YLL 为每 1000 人 1287 人。

结论

越南的 CCU 面临着疾病负担的巨大差异。充足的基础设施和适当的多学科培训对于确保对当前人群需求的适当应对至关重要。

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