老年多器官衰竭发病危险因素病例对照研究

Risk factors of multiple organ failure in the elderly:a case-control study

目的探讨老年多器官功能衰竭(MOFE)患者发病危险因素。方法采用1∶3配比病例对照研究方法。共纳入MOFE患者153例,以年龄(±5岁)、性别、居住地、就诊时间(±1个月)为配比条件,选取对照459例。OR值及其95%CI的计算采用条件logistic回归分析方法。结果 MOFE发病危险因素,经过多因素条件logistic回归模型拟合结果表明,免疫功能低下、肠道营养摄入障碍、感染、电解质紊乱、心律失常、心肌缺血发作、出血性脑卒中、低蛋白血症等8个因素进入模型,其OR(95%CI)分别为4.45(1.42～13.94)、5.34(1.47～19.41)、10.87(3.40～34.97)、33.42(4.7～237.63)、5.31(1.72～16.43)、3.89(1.28～11.85)、50.00(2.86～874.46)、9.31(1.30～66.49),此8个因素为MOFE发生的重要危险因素(P<0.026～0.001)。结论对有上述因素的老年人群应视为MOFE高危对象,重点防范,并控制重要危险因素。

Objective To investigate the risk factors of multiple organ failure in the elderly （MOFE）.Methods A 1∶3 matched case-control study was carried out.A total of 153 MOFE patients and 459 age（±5 years）,sex,residence place,admission time （±1 month）-matched controls were enrolled.Logistic regression was adopted to calculate the odds ratios （OR） and 95% confidence interval （ 95%CI ） associated with candidate risk factors.Results Multivariable logistic regression analysis showed that immunologic deficiency（OR 4.45;95%CI 1.42-13.94）,intestinal nutrition intake dysfunction （OR 5.34;95%CI 1.47-19.41）,infection （OR 10.87;95%CI 3.40-34.97）,electrolyte disturbances （OR 33.42;95%CI 4.7-237.63）,arrhythmia （OR 5.31;95%CI：1.72-16.43）,myocardial ischemia （OR 3.89;95%CI 1.28-11.85）,hemorrhagic stroke （OR 50.0;95%CI 2.86-874.46） and hypoproteinemia （OR 9.31;95%CI 1.30-66.49） were risk factors for MOFE （P0.05）.Conclusion The elderly population who have the above-mentioned risk factors represent a high risk group of MOFE that needs special consideration in order to prevent MOFE.