基于住院病历首页的脑血管病疾病监测研究

发布时间：2018-07-15 19:07

【摘要】：目的利用北京市脑血管疾病住院病历首页及其附页信息，建立北京市脑血管病的疾病监测方式，并提供北京脑血管住院病例的疾病特征，为脑血管病防治决策提供建议。资料及方法研究资料来源于北京市公共卫生信息中心出院病例信息监测系统。提取其中2009-2011年的相关脑血管疾病住院病历首页及其附页信息，并对其流行病学分布特征进行描述性分析研究。结果北京市脑血管病出院数据库完整性及诊断准确性均较好，蛛网膜下腔出血诊断符合率为95.8%，脑出血为97.6%，脑梗死为81.3%。2009-2011年北京市脑血管住院病例数分别为109829、120761、131978例。2009-2011年，脑血管疾病住院病例的平均年龄分别为（65.26±13.68）岁，（65.66±13.47）岁，（65.95±13.48）岁，差异无统计学意义(F=0.14,P=0.79)。北京市脑血管疾病住院病例男性患者比例高于女性。北京脑血管病住院病例亚型中脑梗死构成比约50%，短暂性脑缺血发作约为20%左右。北京市脑血管病住院病例中脑梗死及颅内出血患者住院病死率均呈下降趋势（P0.01），但蛛网膜下腔出血无下降趋势。周末入院脑血管病患者的住院病死率高于非周末入院（P0.01），，北京脑血管病患者入院时间表现为在季节变换时出现入院的小高峰。结论北京建立基于病历首页的脑血管病监测系统具有可行性，将来可进一步与死亡数据库等相连接。北京脑血管病住院病人更年轻化，构成比更接近发达国家，但其短暂脑缺血发作患者住院水平与发达国家仍有差距。脑梗死及脑出血患者的住院病死率有下降趋势,蛛网膜下腔出血无下降趋势。周末入院患者病死率高于非周末入院。入院时间表现为在季节变换时出现入院的小高峰。本研究为脑血管病防治决策提供了数据支持。
[Abstract]:Objective to establish the monitoring mode of cerebrovascular disease in Beijing by using the home page and the page information of cerebrovascular disease in Beijing, and to provide some suggestions for the prevention and treatment of cerebrovascular disease in Beijing.
The data and methods were derived from the discharge case information monitoring system of the Beijing public health information center. The information of the first page of the inpatient records and the page attached to the related cerebrovascular diseases was extracted for 2009-2011 years, and the epidemiological distribution characteristics were analyzed and analyzed.
Results the integrity and diagnostic accuracy of the discharged database of cerebrovascular disease in Beijing were all good, the diagnostic coincidence rate of subarachnoid hemorrhage was 95.8%, cerebral hemorrhage was 97.6%. The number of inpatient cases in Beijing with cerebral infarction was 109829120761131978.2009-2011 years in 81.3%.2009-2011 years, and the average age of inpatient cases of cerebrovascular disease was respectively (65.26 + 13.68) years, (65.66 + 13.47) years, (65.95 + 13.48) years old, the difference was not statistically significant (F=0.14, P=0.79). The proportion of inpatient patients with cerebrovascular disease in Beijing was higher than that of women. The subtype of cerebral infarction in Beijing patients with cerebrovascular disease was about 50%, and the transient ischemic attack was about 20%. The inpatient disease of cerebrovascular disease in Beijing The mortality of patients with cerebral infarction and intracranial hemorrhage showed a downward trend (P0.01), but there was no downward trend in subarachnoid hemorrhage. The mortality rate of hospitalized patients with cerebrovascular disease at the weekend was higher than that of non weekend hospitalization (P0.01). The admission time of the patients with cerebrovascular disease in Beijing showed a small peak at the time of seasonal change.
conclusion
The establishment of a cerebrovascular disease monitoring system based on the front page of the medical records in Beijing is feasible and can be further linked to the death database in the future. The hospitalized patients with cerebrovascular disease in Beijing are younger, and the composition ratio is closer to the developed countries. However, the level of hospitalization of patients with transient ischemic attacks still has a gap with the country. The mortality rate of hospitalized patients had a downward trend, and the subarachnoid hemorrhage did not decline. The fatality rate of the hospitalized patients at the weekend was higher than that of the non weekend hospital. The time of admission was the small peak of admission during the seasonal change. This study provided data support for the prevention and treatment of cerebrovascular disease.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.3;R743

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