台灣地區2005-2007年意外溺水死亡及住院者特性分析

目的：分析意外溺水死亡及住院情形，並進一步找出意外溺水者住院死亡之危險因子。方法：本研究以2005-2007年死因資料及健保住院資料，分析意外溺水死亡及住院者在性別、年齡及月份之分布，並從健保住院資料找出意外溺水住院死亡的危險因子。結果：台灣2005-2007年意外溺水死亡及住院人數分別爲1683人及408人，死亡人數約爲住院人數的4倍。檢視意外溺水者在性別、年齡及月份分布，可發現不論死亡率或住院率皆以男性較高，而在年齡方面，死亡率以65歲以上老人最高，而住院率則是以0-14歲兒童較高；另外，死亡率及住院率皆集中在6-8月較炎熱的月份。在住院死亡部分，住院天數在一天以內(OR=11.31)、心跳停止(OR=28.12)、腦缺氧損傷(OR=4.98)、急性呼吸衰竭(OR=3.49)及進行手術(OR=3.30)皆爲意外溺水者住院死亡的重要影響因子。結論：未來應針對意外溺水高危險族群，擬定合適的防制計畫，並加強夏季之防溺工作。在住院死亡危險因子方面，醫療院所應加強上述病人之照護，防止病患在住院時發生心跳停止、腦缺氧損傷及急性呼吸衰竭，以改善溺水住院患者之預後。

關鍵字

意外溺水；死因統計；全民健保資料庫；住院死亡

並列摘要

Purposes: This study analyzes the characteristics of unintentional drowning cases using vital statistics and hospital data to identify the factors associated with hospital mortality. Methods: This study analyzed mortality data from vital statistics and hospital data from the National Health Insurance Research Database for 2005-2007 to determine the demographic distribution of unintentional drowning victims by gender, age, and month, and to investigate the factors associated with hospital mortality. Results: During the 3-year period of 2005-2007, unintentional drowning accounted for 1,683 deaths and 408 hospitalizations in Taiwan, and the number of deaths was approximately four times that of hospitalization cases. Analytical results for gender, age, and month distributions show that males are at higher risks for both mortality and hospitalization than females. Those aged＞65 have the highest mortality rate, and children aged 0-14 have the highest hospitalization rate. During 1 year, the period with the most unintentional drowning deaths and hospitalization cases was June August. In multiple logistic regression models, hospitalization for≤1 day (OR=11.31), cardiac arrest (OR=28.12), anoxic brain damage (OR=4.98), acute respiratory failure (OR=3.49), and surgery (OR=3.30) significantly affected hospital mortality. Conclusions: Appropriate strategies should be developed that reduce mortality and the hospitali7ation rate caused by unintentional drowning: drowning prevention in summer should be prioritized. Additionally, departments of health and hospitals should enhance care quality to prevent cardiac arrest, anoxic brain damage, and acute respiratory failure to improve the prognoses of patients after drowning.