汶川地震死亡相关因素分析
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摘要
目的分析华西医院收治的地震死亡病例的危险因素和对策。方法收集四川大学华西医院地震死亡病例数据记录,对死亡的年龄分布、创伤病因种类及救治时间等进行回顾性的比较分析。结果截至2008年6月12日共收治2702例伤病员,死亡27例。在地震相关死亡病例中,高龄(≥70岁)、重型颅脑外伤和非外伤原发基础疾病导致的死亡最多。≤1d的死亡与现场急救及转运不当相关,≥1d的死亡与基础疾病相关。结论对70岁以上,尤其是伴发非外伤原发基础疾病的伤员,应加强关注。ICU医师参与院前、院内各专科的现场危重伤员筛查与紧急处置工作有助于降低病死率。
Objective To analyze death causes and relevant factors in victims of Wenchuan earthquake.Methods Medical records of 27 dead patients admitted to West China Hospital during the first 30 days after Wenchuan earthquake were analyzed retrospectively.Patient census data,diagnoses,dispositions,and prognoses were collected.Results A total of 2702 patients with earthquake related injuries were admitted to West China Hospital.The overall mortality rate was 1%(27/2702 patients).The death were associated with age≥70,severe cerebral injuries and severe underlying illness.Mortality rate was highest in aged patients with comorbidities.Conclusions Insufficient pre-hospital treatment and inappropriate transfer procedure may contribute to the early death.Complicated with comorbidities is the leading cause of late death.Earlier involvement of intensivist in medical intervention in such a disaster is demanded.
Objective To analyze death causes and relevant factors in victims of Wenchuan earthquake.Methods Medical records of 27 dead patients admitted to West China Hospital during the first 30 days after Wenchuan earthquake were analyzed retrospectively.Patient census data,diagnoses,dispositions,and prognoses were collected.Results A total of 2702 patients with earthquake related injuries were admitted to West China Hospital.The overall mortality rate was 1%(27/2702 patients).The death were associated with age≥70,severe cerebral injuries and severe underlying illness.Mortality rate was highest in aged patients with comorbidities.Conclusions Insufficient pre-hospital treatment and inappropriate transfer procedure may contribute to the early death.Complicated with comorbidities is the leading cause of late death.Earlier involvement of intensivist in medical intervention in such a disaster is demanded.
引文
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8Bulut M,Fedakar R,Akkose S,et al.Medical experience of a university hospital in Turkey after the1999Marmara earth-quake.Emerg Med J,2005,22:494-498.
2Tanaka H,Oda J,Iwai A,et al.Morbidity and mortality of hospitalized patients after the1995Hanshin-Awaji earth-quake.Am J Emerg Med,1999,17:186-191.
3Sever MS,Vanholder R,Lameire N,et al.Management of crush-related injuries after disasters.N Engl J Med,2006,354:1052-1063.
4Vanholder R,van der Tol A,De Smet M,et al.Earthquakes and crush syndrome casualties:lessons learned from the Kashmir disaster.Kidney Int,2007,71:17-23.
5陈锋,林才经.院前急救与灾难的紧急医疗救援.中华急诊医学杂志,2006,15:479-480.
6缪春勤,李鲁,胡国忠.医院医疗资源整合在台风伤害中临床急救效果评估.中国卫生事业管理,2007,11:739-742.
7Kai T,Ukai T,Ohta M,et al.Hospital disaster preparedness in Osaka,Japan.Prehosp Disaster Med,1994,9:47-52.
8Bulut M,Fedakar R,Akkose S,et al.Medical experience of a university hospital in Turkey after the1999Marmara earth-quake.Emerg Med J,2005,22:494-498.
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