علل مرگ‌ومیر در بیماران مراجعه‌کننده به بخش اورژانس بیمارستان امام خمینی ارومیه

زﻣﯿﻨﻪ و ﻫﺪف: اورژاﻧﺲ ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻪ ﻋﻨﻮان ﺧﻂ اول ﺑﺮﺧﻮرد ﺑﺎ ﺑﯿﻤﺎران دارای اﻫﻤﯿﺖ وﯾﮋهای اﺳﺖ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﯾﻨﮑﻪ ﻣﺮگوﻣﯿﺮ ﺑﯿﻤﺎران در ﺑﺨﺶ اورژاﻧﺲ ﻣﺸﮑﻠﯽ اﺳﺖ ﮐﻪ در ﺳﺎلﻫﺎی اﺧﯿﺮ ﺗﺸﺪﯾﺪ ﯾﺎﻓﺘﻪ اﺳﺖ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎﻫﺪف ﺑﺮرﺳﯽ ﻋﻠﻞ ﻣﺮگ و ﻣﯿﺮ در ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﺑﺨﺶ اورژاﻧﺲ ﺑﯿﻤﺎرﺳﺘﺎن اﻣﺎم ﺧﻤﯿﻨﯽ اروﻣﯿﻪ در ﻧﯿﻤﻪ اول ﺳﺎل 1396 اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ از ﻧﻮع ﺗﻮﺻﯿﻔﯽ ﻣﻘﻄﻌﯽ اﺳﺖ؛ ﮐﻪ ﭘﺲ از ﮐﺴﺐ ﻣﺠﻮز ﭘﺮوﻧﺪه ﺗﻤﺎﻣﯽ اﻓﺮاد ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ در ﺑﺎزه زﻣﺎﻧﯽ 1 ﻓﺮوردﯾﻦ 1396 ﺗﺎ 31 ﺷﻬﺮﯾﻮر 1396 ﮐﻪ ﺑﻪ ﻫﺮ ﻋﻠﺖ در اورژاﻧﺲ ﻓﻮت ﮐﺮده ﺑﻮدﻧﺪ، از ﺑﺎﯾﮕﺎﻧﯽ اﺳﺘﺨﺮاج و ازﻧﻈﺮ ﻣﺘﻐﯿﺮﻫﺎی ﺳﻦ، ﺟﻨﺲ ﺗﺎﻫﻞ، ﻣﺤﻞ ﺳﮑﻮﻧﺖ، ﺷﮑﺎﯾﺖ اوﻟﯿﻪ، ﻣﺪت ﺑﺴﺘﺮی در اورژاﻧﺲ، ﺳﺮوﯾﺲ وﯾﺰﯾﺖ ﺷﺪه، ﻣﺤﻞ ﻓﻮت و ﻋﻠﺖ ﻓﻮت ﺟﻤﻊآوری ﺷﺪ.ﯾﺎﻓﺘﻪﻫﺎ: در ﻣﺠﻤﻮع 133 ﭘﺮوﻧﺪه ﻣﻮردﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ ﮐﻪ 77 (57/9 درﺻﺪ) ﻣﺮد، 114 (85/7 درﺻﺪ) از ﻓﻮتﺷﺪﮔﺎن ﻣﺘﺄﻫﻞ و 71 (53/4 درﺻﺪ) ﺳﺎﮐﻦ ﺷﻬﺮ و ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪﮐﻨﻨﺪﮔﺎن 18/9 ±66/8 ﺑﻮد؛ ﮐﻪ ﺑﯿﺸﺘﺮﯾﻦ ﺷﮑﺎﯾﺖ ذﮐﺮﺷﺪه ﺗﻮﺳﻂ ﺑﯿﻤﺎران و ﯾﺎ ﻫﻤﺮاه ﺑﯿﻤﺎران اﻓﺖ ﻫﻮﺷﯿﺎری و ﮐﻤﺘﺮﯾﻦ ﻣﻮارد ذﮐﺮﺷﺪه ﻣﺮﺑﻮط ﺑﻪ درد ﻗﻔﺴﻪ ﺳﯿﻨﻪ، ﻫﻤﺎﭼﻮری و ﺗﻮرم اﻧﺪام ﺗﺤﺘﺎﻧﯽ ﺑﻮد و زﻣﺎن ﺣﻀﻮر درﺻﺪ ﺑﺎﻻﯾﯽ از ﻓﻮتﺷﺪﮔﺎن (58/6 درﺻﺪ) 24 ﺳﺎﻋﺖ و ﮐﻤﺘﺮ از آن ﺑﻮده اﺳﺖ. ﺑﯿﺸﺘﺮﯾﻦ ﻋﻠﻞ ﻣﺮگوﻣﯿﺮ اﯾﺴﺖ ﻗﻠﺒﯽ ﺗﻨﻔﺴﯽ و ﺑﯿﻤﺎری ﻫﺎی ﻗﻠﺒﯽ ﻋﺮوﻗﯽ ﺑﻮده و درﻧﻬﺎﯾﺖ در ﺑﺮرﺳﯽ ﻣﺪتزﻣﺎن اﺑﺘﻼ و ﻣﺸﮑﻞدار ﺑﻮدن ﺑﯿﻤﺎران (ﺣﺎد ﯾﺎ ﻣﺰﻣﻦ)، 38 ﻣﻮرد (28/6 درﺻﺪ) دﭼﺎر اﺧﺘﻼل ﺣﺎد و 95 ﻣﻮرد (71/4 درﺻﺪ) ﺳﺎﺑﻘﻪ ﻗﺒﻠﯽ ﺑﯿﻤﺎری ﻣﺰﻣﻦ داﺷﺘﻨﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮی: ﺑﯿﺸﺘﺮ ﻋﻠﻞ ﻣﺮگوﻣﯿﺮ، اﯾﺴﺖ ﻗﻠﺒﯽ ﺗﻨﻔﺴﯽ و ﻣﺸﮑﻼت ﻗﻠﺒﯽ ﻋﺮوﻗﯽ ﺑﻮده ﮐﻪ ﻟﺬا ﺑﯿﺎنﮐﻨﻨﺪه اﻫﻤﯿﺖ ﮐﻨﺘﺮل و ﭘﯿﺸﮕﯿﺮی از اﯾﻦ ﺑﯿﻤﺎریﻫﺎ و از ﻃﺮف دﯾﮕﺮ ﺑﺮﻧﺎﻣﻪرﯾﺰی ﻣﻨﺎﺳﺐ، آﻣﻮزش ﮐﺎرﮐﻨﺎن و ﺗﺠﻬﯿﺰ ﮐﺮدن ﺑﺨﺶ اورژاﻧﺲ در ﮐﺎﻫﺶ ﻣﻮارد ﻣﺮگ وﻣﯿﺮ ﺗﺄﺛﯿﺮﮔﺬار ﺑﺎﺷﺪ.

Causes of Mortality in Patients Referred to the Emergency Department of Imam Khomeini Hospital in Urmia

Introduction: Hospital emergencies are of particular importance as they are considered as the firstline treatment for patients. Patient mortality in the emergency department is considered to be a problem as it has intensified in recent years. The aim of this study was to investigate the causes of mortality in patients admitted to the Emergency Department of Imam Khomeini Hospital in Urmia in the first half of 2017. Materials and Methods: In this crosssectional descriptive study, after obtaining permission, the medical file of all those patients who had referred to the emergency department during the period of April 1st to September 31st, 2017 and who had died in the emergency for any reason was gathered. Data were collected from the archive and were collected for variables such as age, sex, marital status, residence, initial complaint, length of hospital stay, visitation service, place of death and cause of death. Results: A total of 133 cases were studied, of which 77 (57.9%) were male, 114 (85.7%) were married and 71 (53.4%) were residents of Urmia and the mean age of patients was 66/8±18/9. The most common complaints reported by patients or their companions were about consciousness loss and the least reported were chest pain, hematuria, and lower extremity swelling, respectively. A high percentage of mortality (58.6%) had occurred in patients who had been in the emergency department for 24 hours or less. The most common causes of mortality were cardiopulmonary deaths and cardiovascular disease, and ultimately in the evaluation of the duration of the disease (acute or chronic), 38 (28.6%) had acute disorder and 95 (71.4%) had a previous chronic disease. Conclusion: According to the results of the present study, most of the causes of mortality included cardiopulmonary arrest and cardiovascular problems. These findings reveal the  importance of controlling and preventing these diseases and on the other hand, shows the necessity of proper planning, staff training and equipping the emergency departments in order to reduce mortality rates.