老年多器官功能不全综合征发病危险因素的逐步Logistic回归分析

Stepwise Logistic Regression Analysis of Risk Factors of Multiple Organ Dysfunction Syndrome in Elderly

目的探讨老年多器官功能不全综合征(MODSE)的发病危险因素。方法回顾性调查2001—2006年因肺部感染在我院住院或住院期间出现肺部感染的驻石家庄地区60岁以上的师以上军队离退休干部393例的病历资料,根据肺部感染是否诱发MODSE将393例患者分为MODSE组(169例)和非MODSE组(224例)。先以单因素分析筛选有统计学意义的发病危险因素,再通过逐步Logistic回归分析筛选MODSE发病的独立危险因素。结果单因素分析显示:年龄、慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、肺心病、冠心病、慢性心功能不全、脑血管疾病、颈椎病、慢性肝炎与肝硬化、糖尿病、高尿酸血症、慢性肾功能不全、恶性肿瘤、血红蛋白、清蛋白、尿素氮、肌酐、空腹血糖是MODSE发病的危险因素;逐步Logistic回归分析显示:慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、慢性心功能不全、脑血管疾病、糖尿病、慢性肾功能不全、低血红蛋白、低清蛋白、高血尿素氮和高空腹血糖是MODSE发病的独立危险因素。结论慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、慢性心功能不全、脑血管疾病、糖尿病、慢性肾功能不全、低血红蛋白、低血清清蛋白,高血尿素氮和高空腹血糖是MODSE发病的独立危险因素。

Objective To study the risk factors of multiple organ dysfunction syndrome in elderly (MODSE).Methods A retrospective study was conducted on data of 393 patients aging over 60 hospitalized due to lung infection or having lung infection in hospital from 2001 to 2006.The patients were divided into group MODSE(n=196) and group non-MODSE(n=224).Risk factors of statistical significance were first screened out by single factor analysis,and then independent risk factors by stepwise Logistic regression analysis.Results Single factor analysis showed that age,chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary interstitial fibrosis,pulmonary heart disease,coronary heart disease,chronic cardiac insufficiency,cerebrovascular disease,cervical spondylosis,chronic hepatitis and cirrhosis,diabetes,hyperuricemia,chronic renal failure,malignant tumor,hemoglobin,albumin,urea nitrogen,creatinine and fasting blood glucose were risk factors of MODSE.Stepwise Logistic regression analysis showed that chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary fibrosis,chronic cardiac insufficiency,cerebrovascular disease,diabetes,chronic renal failure,low hemoglobin,low albumin,high urea nitrogen and high fasting blood glucose were independent risk factors of MODSE.Conclusion Chronic obstructive pulmonary disease,chronic respiratory failure,pulmonary fibrosis,chronic cardiac insufficiency,cerebrovascular disease,diabetes,chronic renal failure,low hemoglobin,low albumin,high urea nitrogen and high fasting blood glucose were independent risk factors of MODSE.