慢性阻塞性肺疾病急性加重期住院患者死亡相关因素分析

Death-related factors among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease

目的了解慢性阻塞性肺疾病急性加重期(AECOPD)住院患者病死率及死亡相关因素。方法采用回顾性分析,收集北京大学第三医院2007年1月至2008年12月呼吸科收住的AECOPD患者138例。总结患者特点,并采用单因素及多因素Logistic回归进行分析。结果 AECOPD住院患者院内病死率为21.7%。单因素分析发现下列因素与AECOPD住院死亡相关:年龄、住院时间长短、PASP、入住ICU、合并肺炎、贫血、肾功能不全、Ⅱ型呼吸衰竭、心房颤动、休克、气胸。多因素Logistic回归分析提示肺炎(OR=42.488)、高PASP(≥45mmHg)(OR=15.914)、贫血(OR=7.693)、心房颤动(OR=6.215)以及入住ICU(OR=4.927)是AECOPD患者住院死亡的独立危险因素。结论 AECOPD住院患者病死率高,肺炎、高PASP(≥45mmHg)、贫血、心房颤动以及入住ICU是AECOPD患者住院死亡的独立危险因素。

Objective To study the mortality and death-related factors among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Data of 138 AECOPD patients hospitalized in Peking University Third Hospital between January 2007 and December 2008 were retrieved and analyzed retrospectively. The characteristics of patients were summarized. Besides, univariate and multivariate logistic regressions were used for analysis. Results The mortality of AECOPD in-patients was 21.7%. According to univariate analysis, the following factors were associated with in-hospital mortality：age, length of hospital stay, pulmonary artery systolic pressure （ PASP）, admission to ICU, presence of pneumonia, anemia, renal insufficiency, type Ⅱ respiratory failure, atrial fibrillation, shock and pneumothorax. Multivariate logistic regress analysis showed that comorbidities with pneumonia （ OR = 42. 488 ）, high PASP （ ≥ 45 mmHg） （ OR = 15. 914 ）, anemia （ OR = 7. 693 ） ,atrial fibrillation （OR = 6. 215 ）, and admission to ICU （OR = 4. 927 ） were independent risk factors for death from AECOPD. Conclusion Mortality in hospitalized patients with AECOPD was high. Presence of pneu- monia,high PASP （ ≥45 mmHg）, anemia, atrial fibrillation and admission to ICU were independent risk factors for death from AECOPD.