单中心不同年龄急性心肌梗死患者的住院时间和费用分析
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摘要
目的分析不同年龄急性心肌梗死患者的平均住院日和花费情况。方法收集泰安市中心医院2013年7月1日至2018年6月30日因急性心肌梗死住院的4 034例患者资料,按年龄分为3组:中年组(45≤年龄<60周岁)1 093例、老年组(60≤年龄<80周岁)2 365例和高龄组(年龄≥80周岁)576例。比较不同年龄组急性心肌梗死患者的平均住院日及花费情况。结果老年组患者平均住院日高于中年组和高龄组,差异有统计学意义[(11.5±7.0)d比(10.9±5.5)d,P=0.012;(11.5±7.0)d比(10.8±7.6)d,P=0.029];3组男性平均住院日比较,差异有统计学意义(F=3.613,P=0.027),其中老年组男性平均住院日高于中年组[(11.6±7.5)d比(10.9±5.6)d,P=0.009];3组药物花费比较,差异无统计学意义(F=2.248,P=0.106);住院总费用方面,3组间两两比较差异均有统计学意义(均为P<0.05),且随着年龄增长,住院总费用呈下降趋势。结论老年患者的平均住院日显著高于中年和高龄患者;随着年龄增长,住院总费用呈下降趋势。
Objective To analyze the average hospitalization days and expenses of patients with acute myocardial infarction(AMI) of different age. Methods Data of 4 034 patients with AMI hospitalized in Taian Central Hospital from July 1, 2013 to June 30, 2018 were collected. Based on age, all patients were divided into three groups: 1 093 cases in middle-age group(45≤age<60 years), 2 365 cases in old age group(60≤age<80 years) and 576 cases in advanced age group(age≥80 years). The average hospitalization days and expenses in hospital were compared among the three groups. Results The average length of stay in hospital in the old age group were significantly higher than those in the middle-age group [(11.5 +7.0) d vs.(10.9+5.5)d, P=0.012] and the advanced age group [(11.5+7.0)d vs.(10.8+7.6)d, P=0.029]. Pharmacy costs were similar among the three groups(F=2.248, P=0.106), but the middle-age group was associated with significantly higher total hospitalization expenses compared with the other two groups(both P<0.05). Conclusions The average hospitalization days is significantly higher in the old age group than those in the middle-aged and advanced age groups. With the increase of age, there is a downward trend of less total hospitalization expenses.
Objective To analyze the average hospitalization days and expenses of patients with acute myocardial infarction(AMI) of different age. Methods Data of 4 034 patients with AMI hospitalized in Taian Central Hospital from July 1, 2013 to June 30, 2018 were collected. Based on age, all patients were divided into three groups: 1 093 cases in middle-age group(45≤age<60 years), 2 365 cases in old age group(60≤age<80 years) and 576 cases in advanced age group(age≥80 years). The average hospitalization days and expenses in hospital were compared among the three groups. Results The average length of stay in hospital in the old age group were significantly higher than those in the middle-age group [(11.5 +7.0) d vs.(10.9+5.5)d, P=0.012] and the advanced age group [(11.5+7.0)d vs.(10.8+7.6)d, P=0.029]. Pharmacy costs were similar among the three groups(F=2.248, P=0.106), but the middle-age group was associated with significantly higher total hospitalization expenses compared with the other two groups(both P<0.05). Conclusions The average hospitalization days is significantly higher in the old age group than those in the middle-aged and advanced age groups. With the increase of age, there is a downward trend of less total hospitalization expenses.
引文
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[6] 罗鹏飞, 俞浩, 韩仁强, 等. 2013年江苏居民循环系统疾病死亡及潜在减寿分析[J]. 江苏预防医学, 2017, 28(1): 35-38. DOI: 10.13668/j.issn.1006-9070.2017.01.11. Luo PF,Yu H, Han RQ, et al. Mortality and PYLL caused by circulatory system diseases among residents in jiangsu province, 2013 [J]. Jiangsu J Prev Med, 2017, 28(1): 35-38. DOI:10.13668/j.issn.1006-9070.2017.01.11.
[7] 隋辉, 陈伟伟, 王文.《中国心血管病报告2015》要点解读 [J]. 中国心血管杂志, 2016, 21(4): 259-261. DOI: 10.3969/j.issn.1007-5410.2016.04.001. Sui H, Chen WW, Wang W. Interpretation of Report on Cardiovascular Diseases in China (2015)[J]. Chin J Cardiovasc Med, 2016, 21(4): 259-261. DOI: 10.3969/j.issn.1007-5410.20 16 .04.001.
[8] 高晓津, 杨进刚, 杨跃进, 等. 中国急性心肌梗死患者心血管危险因素分析[J]. 中国循环杂志, 2015, 30(3): 206-210. DOI: 10.3969/j.issn.1000-3614.2015.03.003. Gao XJ, Yang JG, Yang YJ, et al. Cardiovascular Risk Factor Analysis for Acute Myocardial Infarction Patients in China [J]. Chinese Circulation Journal, 2015, 30(3): 206-210. DOI: 10.3969/j.issn.1000-3614.2015.03.003.
[9] 杨菲飞, 陈鑫. 2012-2016年无锡市梁溪区心肌梗死发病率趋势[J]. 江苏预防医学, 2018, 29(2): 168-170. DOI: 10.13668/j.issn.1006-9070.2018.02.016. Yang FF, Chen X. Incidence Trend of Myocardial Infarction in Liangxi District, Wuxi City, 2012-2016[J]. Jiangsu J Prev Med, 2018, 29(2): 168-170. DOI: 10.13668/j.is-sn.1006-9070.2018.02.016.
[10] 韩翰, 王岚峰, 陆莹, 等. 年龄对急性心肌梗死患者近期预后影响的分析[J]. 现代生物学进展, 2015, 15(29): 5667-5669. DOI: 10.13241/j.cnki.pmb.2015.29.019. Han H, Wang LF, Lu Y, et al. Effect of Age on Short-term Prognosis in the Hospitalized Patients with AMI [J]. Progress in Modern Biomedicine, 2015, 15(29): 5667-5669. DOI: 10.13241 /j.cnki.pmb.2015.29.019.
[11] Ma Y, Li L, Shang XM, et al. Analysis of factors related to short-term prognosis in patients undergoing percutaneous coronary intervention for acute myocardial infarction [J]. Exp Ther Med, 2013, 5(4): 1206-1210.
[12] 刘丹, 李永东. 不同年龄及性别心肌梗死临床特点分析[J]. 疾病监测与控制杂志, 2013, 7(11): 659-661. Liu D, Li YD. Clinical characteristics of acute myocardial infarcation in different ages and sexes [J]. J Diseases Monitor & Control, 2013, 7(11): 659-661.
[13] 初慧中. 急性心肌梗死患者性别差异的临床比较分析[J]. 中国当代医院, 2017, 24(36): 36-39. DOI: 10.3969/j.issn.1674-4721.2017.36.011. Chu HZ. Clinical analysis of gender differences in patients with acute myocardial infarction [J]. China Modern Medicine, 2017, 24(36): 36-39. DOI: 10.3969/j. issn. 1674-4721. 2017. 36. 011.
[14] 皮林, 孙子程, 李莉, 等. 急性心肌梗死住院患者临床特点的性别差异及死亡危险因素分析[J]. 中国医刊, 2017, 52(5): 30-33. DOI: 10.3969/j.issn.1008-1070.2017.05.010. Pi L, Sun ZC, Li L, et al. Analysis of clinical characteristics of male and female inpatients with acute myocardial infarction [J]. Chinese Journal of Medicine, 2017, 52(5): 30-33. DOI: 10.3969 /j. issn.1008-1070.2017.05.010.
[15] 李爱军, 李南, 齐维鹏, 等. 急性ST段抬高型心肌梗死行急诊经皮冠状动脉介入治疗患者平均住院日的影响因素分析[J].中国医药, 2016, 11(5): 638-641. DOI: 10.3760/cma.j.issn.1673-4777.2016.05.004. Li AJ, Li N, Qi WP, et al. Analysis of influencing factors of average length of stays in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention [J]. China Medicine, 2016, 11(5): 638-641. DOI: 10.3760/cma.j.issn.1673-4777.2016.05.004.
[16] 李静, 李希, 胡爽, 等. 2001-2011年中西部城市ST段抬高型心肌梗死诊疗趋势[J]. 中国心血管杂志, 2016, 21(3): 177-183. DOI: 10.3969/ cma. j. issn. 1007-5410. 2016. 03. 003. Li J, Li X, Hu S, et al. ST-segment elevation myocardial infarction in central-western urban China from 2001 to 2011: the China PEACE-retrospective acute myocardial infarction study [J]. Chin J Cardiovasc Med, 2016, 21(3): 177-183. DOI: 10.3969/cma.j.issn.1007-5410.2016.03.003.
[17] 蔡乐红, 杨志彩, 张伟, 等. 急性心肌梗死患者住院费用分析[J]. 现代预防医学, 2013, 40(21): 3977-3983. Cai LH, Yang ZC, Zhang W, et al. Analysis of the hospitalization cost of acute myocardial infarction inpatients [J]. Modern Preventive Medicine, 2013, 40(21): 3977-3983.
[18] 孙涛. 急性心肌梗死患者住院费用构成分析和影响因素研究[J]. 中国病案, 2014, 15(8): 59-61. DOI: 10.3969/j.issn.1672-2566.2014.08.028. Sun T. Study on the Composition and Influential Factors of Hospitalization Costs of Acute Myocardial Infarction Patients [J]. Chinese Medical Record, 2014, 15(8): 59-61. DOI: 10.3969/j.issn.1672-2566.2014.08.028.
[2] Unverzagt S, Buerke M, de Waha A, et al. Intra-aortic balloon pump counterpulsation ( IABP) for myocardial infarction complicated by cardiogenic shock [J]. Cochrane Database Syst Rev, 2015, 3(3): 2183-2183. DOI: 10.1016/S0735-1097(10)61088-1.
[3] 张东青, 宋显晶, 朴哲浩, 等. 急性心肌梗死合并心源性休克器械化治疗进展[J]. 心血管病学进展, 2018, 39(1): 90-94. DOI: 10.16806/j.cnki.issn.1004-3934.2018.01.022. Zhang DQ, Song XJ, Piao ZH, et al. Advances in Treatment of Acute Myocardial Infarction with Cardiogenic Shock [J]. Adv Cardiovasc Dis, 2018, 39(1): 90-94. DOI:10.16806/j.cn- ki.issn.1004-3934.2018.01.022.
[4] 郭玲昌. 急性心肌梗死患者并发首次心力衰竭的影响因素和预防分析[J]. 河南医学研究, 2018, 27(13): 2355-2357. DOI: 10.3969/j.issn.1004-437X.2018.13. 022. Guo LC. Influencing factors and prevention of first heart failure in patients with acute myocardial [J]. Henan Medical Research, 2018, 27(13): 2355-2357. DOI: 10.3969/j.issn.1004- 437X. 2018. 13. 022.
[5] 葛均波, 徐永健. 内科学(第8版)[M]. 北京: 人民卫生出版社, 2013. Ge JB, Xu YJ. Internal Medicine (8th Edition)[M]. Beijing: People's Health Publishing House, 2013.
[6] 罗鹏飞, 俞浩, 韩仁强, 等. 2013年江苏居民循环系统疾病死亡及潜在减寿分析[J]. 江苏预防医学, 2017, 28(1): 35-38. DOI: 10.13668/j.issn.1006-9070.2017.01.11. Luo PF,Yu H, Han RQ, et al. Mortality and PYLL caused by circulatory system diseases among residents in jiangsu province, 2013 [J]. Jiangsu J Prev Med, 2017, 28(1): 35-38. DOI:10.13668/j.issn.1006-9070.2017.01.11.
[7] 隋辉, 陈伟伟, 王文.《中国心血管病报告2015》要点解读 [J]. 中国心血管杂志, 2016, 21(4): 259-261. DOI: 10.3969/j.issn.1007-5410.2016.04.001. Sui H, Chen WW, Wang W. Interpretation of Report on Cardiovascular Diseases in China (2015)[J]. Chin J Cardiovasc Med, 2016, 21(4): 259-261. DOI: 10.3969/j.issn.1007-5410.20 16 .04.001.
[8] 高晓津, 杨进刚, 杨跃进, 等. 中国急性心肌梗死患者心血管危险因素分析[J]. 中国循环杂志, 2015, 30(3): 206-210. DOI: 10.3969/j.issn.1000-3614.2015.03.003. Gao XJ, Yang JG, Yang YJ, et al. Cardiovascular Risk Factor Analysis for Acute Myocardial Infarction Patients in China [J]. Chinese Circulation Journal, 2015, 30(3): 206-210. DOI: 10.3969/j.issn.1000-3614.2015.03.003.
[9] 杨菲飞, 陈鑫. 2012-2016年无锡市梁溪区心肌梗死发病率趋势[J]. 江苏预防医学, 2018, 29(2): 168-170. DOI: 10.13668/j.issn.1006-9070.2018.02.016. Yang FF, Chen X. Incidence Trend of Myocardial Infarction in Liangxi District, Wuxi City, 2012-2016[J]. Jiangsu J Prev Med, 2018, 29(2): 168-170. DOI: 10.13668/j.is-sn.1006-9070.2018.02.016.
[10] 韩翰, 王岚峰, 陆莹, 等. 年龄对急性心肌梗死患者近期预后影响的分析[J]. 现代生物学进展, 2015, 15(29): 5667-5669. DOI: 10.13241/j.cnki.pmb.2015.29.019. Han H, Wang LF, Lu Y, et al. Effect of Age on Short-term Prognosis in the Hospitalized Patients with AMI [J]. Progress in Modern Biomedicine, 2015, 15(29): 5667-5669. DOI: 10.13241 /j.cnki.pmb.2015.29.019.
[11] Ma Y, Li L, Shang XM, et al. Analysis of factors related to short-term prognosis in patients undergoing percutaneous coronary intervention for acute myocardial infarction [J]. Exp Ther Med, 2013, 5(4): 1206-1210.
[12] 刘丹, 李永东. 不同年龄及性别心肌梗死临床特点分析[J]. 疾病监测与控制杂志, 2013, 7(11): 659-661. Liu D, Li YD. Clinical characteristics of acute myocardial infarcation in different ages and sexes [J]. J Diseases Monitor & Control, 2013, 7(11): 659-661.
[13] 初慧中. 急性心肌梗死患者性别差异的临床比较分析[J]. 中国当代医院, 2017, 24(36): 36-39. DOI: 10.3969/j.issn.1674-4721.2017.36.011. Chu HZ. Clinical analysis of gender differences in patients with acute myocardial infarction [J]. China Modern Medicine, 2017, 24(36): 36-39. DOI: 10.3969/j. issn. 1674-4721. 2017. 36. 011.
[14] 皮林, 孙子程, 李莉, 等. 急性心肌梗死住院患者临床特点的性别差异及死亡危险因素分析[J]. 中国医刊, 2017, 52(5): 30-33. DOI: 10.3969/j.issn.1008-1070.2017.05.010. Pi L, Sun ZC, Li L, et al. Analysis of clinical characteristics of male and female inpatients with acute myocardial infarction [J]. Chinese Journal of Medicine, 2017, 52(5): 30-33. DOI: 10.3969 /j. issn.1008-1070.2017.05.010.
[15] 李爱军, 李南, 齐维鹏, 等. 急性ST段抬高型心肌梗死行急诊经皮冠状动脉介入治疗患者平均住院日的影响因素分析[J].中国医药, 2016, 11(5): 638-641. DOI: 10.3760/cma.j.issn.1673-4777.2016.05.004. Li AJ, Li N, Qi WP, et al. Analysis of influencing factors of average length of stays in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention [J]. China Medicine, 2016, 11(5): 638-641. DOI: 10.3760/cma.j.issn.1673-4777.2016.05.004.
[16] 李静, 李希, 胡爽, 等. 2001-2011年中西部城市ST段抬高型心肌梗死诊疗趋势[J]. 中国心血管杂志, 2016, 21(3): 177-183. DOI: 10.3969/ cma. j. issn. 1007-5410. 2016. 03. 003. Li J, Li X, Hu S, et al. ST-segment elevation myocardial infarction in central-western urban China from 2001 to 2011: the China PEACE-retrospective acute myocardial infarction study [J]. Chin J Cardiovasc Med, 2016, 21(3): 177-183. DOI: 10.3969/cma.j.issn.1007-5410.2016.03.003.
[17] 蔡乐红, 杨志彩, 张伟, 等. 急性心肌梗死患者住院费用分析[J]. 现代预防医学, 2013, 40(21): 3977-3983. Cai LH, Yang ZC, Zhang W, et al. Analysis of the hospitalization cost of acute myocardial infarction inpatients [J]. Modern Preventive Medicine, 2013, 40(21): 3977-3983.
[18] 孙涛. 急性心肌梗死患者住院费用构成分析和影响因素研究[J]. 中国病案, 2014, 15(8): 59-61. DOI: 10.3969/j.issn.1672-2566.2014.08.028. Sun T. Study on the Composition and Influential Factors of Hospitalization Costs of Acute Myocardial Infarction Patients [J]. Chinese Medical Record, 2014, 15(8): 59-61. DOI: 10.3969/j.issn.1672-2566.2014.08.028.
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