Objective To describe hospitalization patterns, major disease spectra, and clinical outcomes among middle-aged and elderly inpatients in Northwest China between 2020 and 2024. Methods A retrospective cohort study was conducted using electronic medical records from a tertiary hospital. A total of 108,027 admissions were reviewed, and 91,470 were included after excluding cases coded as Z51 (other medical care). Demographic features, length of stay, major diagnoses, and in-hospital mortality were summarized. Annual differences and temporal trends were assessed using appropriate statistical tests. Results Hospitalizations increased from 16,407 in 2020 to 27,393 in 2024. Patients aged ≥65 years accounted for roughly three-quarters of admissions, with those aged 65–74 years forming the largest subgroup (46.6%). The overall in-hospital mortality was 1.29%, which scaled significantly with age and peaked at 1.77% in 2023 alongside a surge in respiratory admissions. While males consistently accounted for ∼55% of admissions, they exhibited a higher mortality rate than females (1.22% vs. 0.88%) and dominated specific admissions like chronic obstructive pulmonary disease (70.3% male). The median length of stay declined from 9 to 7 days. Chronic non-communicable diseases dominated the inpatient spectrum, with senile cataract, cerebral infarction, angina pectoris, and COPD being the most frequent diagnoses. Conclusion Non-communicable diseases and age-related conditions remain the primary drivers of hospitalization, but their patterns are highly dynamic. The escalating mortality in the oldest-old and marked post-pandemic respiratory surges highlight the critical role of underlying frailty. Alongside improvements in heart failure management, healthcare systems must prioritize targeted primary prevention, aggressive multimorbidity management, and robust long-term care to address these shifting vulnerabilities.
Quan et al. (Wed,) studied this question.