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目的:探讨大型综合性医院急诊抢救死亡患者的临床特征。方法:对1880例急诊临床死亡患者的临床特征进行回顾性分析,主要内容包括年龄、性别、既往病史、首发症状、来诊方式、来诊时间和死因诊断等。结果:①本组前五位死亡原因为原因不明死亡(42.23%),创伤(17.61%)、脑血管疾病(15.32%)、心血管疾病(7.34%)和恶性肿瘤晚期(4.30%);②创伤死亡患者的男性明显高于女性(男/女:261/70),也显著高于其他各组(均P<0.01);③原因不明死亡、心血管系统疾病、脑血管疾病和恶性肿瘤晚期的急诊死亡年龄特征呈增龄变化,而创伤急诊死亡高峰年龄段在15～30岁(38.37%,127/331);④发病至就诊时间<1h为59.04%(1110/1880),全部死亡患者中由120送诊的只有29.08%(528/1880)。⑤发病至死亡时间<1h的为39.89%(750/1880),不明原因患者在发病1h内急诊死亡占66.25%(526/794),高于创伤(41.69%,138/331),且差异有统计学意义(χ2=58.239,P<0.01)。结论:急诊抢救死亡多为发病后<1h就诊,发病至死亡<1h,和死亡原因不明的,和非120送诊的患者,这提示加强急诊患者最初的诊治尤为重要。
Objective: To investigate the clinical characteristics of emergency patients in large general hospitals. Methods: The clinical features of 1880 emergency patients were retrospectively analyzed. The main contents included age, gender, previous medical history, first symptom, method of visit, consultation time and cause of death. Results: The first five deaths in this group were unexplained death (42.23%), trauma (17.61%), cerebrovascular disease (15.32%), cardiovascular disease (7.34%) and advanced malignant tumor (4.30%); The death rate of trauma patients was significantly higher than that of women (male / female: 261/70), and significantly higher than those of other groups (all P <0.01); ③ unexplained deaths, cardiovascular diseases, cerebrovascular diseases and advanced malignant tumors (38.37%, 127/331) in the emergency department of the emergency department; (59.04%) (1110/1880) in the emergency department <1 hour, all the patients died Only 120% (528/1880) of the 120 patients were referred for consultation. (5) The incidence of death to <1 h was 39.89% (750/1880), the rate of emergency death was 66.25% (526/794) within 1 hour after onset of unknown cause, higher than that of trauma (41.69%, 138/331) Statistical significance (χ2 = 58.239, P <0.01). Conclusions: Most of the emergency rescues for emergency treatment are patients who have been treated for less than 1 hour after onset, have died to less than 1 hour, have unknown cause of death, and have not received 120 cases. This suggests that it is particularly important to strengthen the initial diagnosis and treatment of emergency patients.