【摘要】 目的 了解2018—2024年海南省常住居民心血管疾病(cardiovascular disease,CVD)死亡地点分布特征，探索社会人口学特征、疾病相关因素、地区因素等与CVD患者死亡地点之间的关系。方法 利用全国人口死亡信息登记管理系统中海南省死因数据，描述CVD死亡地点分布情况，采用单因素和多因素logistic回归模型分析家中CVD死亡的影响因素。结果 2018—2024年，共收集CVD死亡个案136 378例，其中86.73%的个案在家中死亡，9.38%的个案在医疗卫生机构死亡。通过调整其他因素后分析发现：与男性相比，女性(OR=1.07,95%CI:1.03～1.11)更易于死在家中；随着年龄的增长，死在家中的可能性逐渐升高；与汉族相比，黎族(OR=1.64,95%CI:1.53～1.76)更易于死在家中；与已婚者相比，丧偶者(OR=1.46,95%CI:1.38～1.54)更可能在家中死亡，而未婚者(OR=0.49,95%CI:0.45～0.53)和离婚者(OR=0.51,95%CI:0.44～0.59)在家中死亡的可能性较低；文化程度越高，死在家中的可能性越低；与工人相比，农民(OR=2.79,95%CI:2.56～3.04)在家中死亡的可能性高于其他职业；与风湿性心脏病相比，高血压及并发症(OR=1.29,95%CI:1.10～1.51)在家中死亡的可能性高于其余CVD亚型；与东部地区相比，中部地区(OR=0.66,95%CI:0.63～0.70)和西部地区(OR=0.85,95%CI:0.82～0.89)死在家中的可能性降低。结论 海南省常住居民CVD死亡地点以家中为主，女性、高龄、黎族、丧偶、文化程度低、农民、高血压及并发症和东部地区患者在家中死亡的可能性更大。因此，应综合考虑不同特征CVD患者的具体情况，优化医疗卫生资源配置，提高临床干预和救治能力；同时建立临床护理与社区/家庭相结合的照护模式，以改善临终护理质量。更多还原

【Abstract】 Objective To understand the distribution characteristics of cardiovascular disease(CVD) deaths among permanent residents in Hainan Province from 2018 to 2024, and to explore the relationship between socio-demographic characteristics,disease-related factors, regional factors, etc. and the place of death of CVD patients. Methods Using Hainan Province’s cause-of-death data from the National Mortality Surveillance System, we described the distribution of CVD death places, and used univariate and multivariable logistic regression models to analyze the influencing factors of CVD deaths at home.Results From 2018 to 2024, a total of 136 378 CVD deaths were collected, with 86.73% occurring at home and 9.38%occurring in medical and healthcare institutions. After adjusting for other factors, the analysis revealed that females( OR=1.07, 95% CI: 1.03-1.11) were more likely to die at home than males; the likelihood of dying at home grew gradually with age; compared to the Han ethnicity, the Li ethnicity(OR=1.64, 95% CI: 1.53-1.76) was more likely to die at home; compared to married individuals, widowed individuals(OR=1.46, 95% CI: 1.38-1.54) were more likely to die at home than unmarried(OR=0.49, 95% CI: 0.45-0.53) and divorced individuals(OR=0.51, 95% CI: 0.44-0.59); the higher the educational level, the lower the likelihood of dying at home; compared to workers, farmers(OR=2.79, 95% CI: 2.56-3.04) were more likely to die at home than individuals in other occupations; compared to rheumatic heart disease, hypertension and its complications(OR=1.29, 95% CI: 1.10-1.51) were more likely to die at home than other CVD subtypes; compared to the Eastern region, the Central region(OR=0.66, 95% CI: 0.63-0.70) and the Western region(OR=0.85, 95% CI: 0.82-0.89) were less likely to die at home. Conclusion The place of death for CVD among permanent residents in Hainan Province is mainly at home, and patients who are female, elderly, Li ethnicity, widowed, with low educational level, farmers, hypertension and its complications, and patients in the eastern region are more likely to die at home. Therefore, the specific conditions of CVD patients with different characteristics should be considered comprehensively to optimize the allocation of healthcare resources and improve clinical intervention and treatment capacity; meanwhile, a care model combining clinical care and community/home should be established to improve the quality of end-of-life care.更多还原