老年临终期肿瘤患者合并肺部感染的危险因素分析

Risk factors of pulmonary infection in elderly patients with terminal stage cancer

目的：分析老年临终期恶性肿瘤患者肺部感染的发生情况及其危险因素。方法回顾性地分析2012年10月至2013年11月期间在北京老年医院住院治疗的143例老年临终期恶性肿瘤患者的临床资料，采用多因素logistic回归分析方法对87例并发肺部感染病例（观察组）及56例未并发肺部感染病例（对照组）进行比较分析。结果 logistic多因素逐步回归分析显示，肺癌[比值比（ OR）＝4.137，95%置信区间（ CI）为1.967～14.479]、意识障碍（ OR＝3.728，95%CI为1.313～8.315）、低蛋白血症（ OR＝2.960，95%CI为1.300～6.739）、住院天数（ OR＝2.611，95%CI为1.056～6.451）、体力状况（ OR＝2.187，95%CI为1.345～4.071）、糖尿病（OR＝1.937，95%CI为1.159～3.238）、慢性阻塞性肺疾病（OR＝1.823，95%CI为1.056～3.891）与老年临终期恶性肿瘤患者并发肺部感染有相关性（均P＜0.05）。结论肺部感染是老年临终期恶性肿瘤患者的常见并发症，肺癌、伴有意识障碍、低蛋白血症、住院时间长、卧床以及合并慢性基础病（糖尿病和慢性阻塞性肺疾病）者是老年临终肿瘤患者并发肺部感染的危险。

Objective To identify the risk factors of pulmonary infection in the elderly patients with terminal-stage cancer in hospice. Methods Clinical data of 143 elderly patients with terminal-stage cancer hospitalized in our department from October 2012 to November 2013 were collected and retrospectively analyzed. A multivariate logistic regression analysis was carried out in the patients with pulmonary infection （n=87） and those without （n=56） for the risk factors of pulmonary infection. Results Variables significantly associated with increased risk of pulmonary infection included lung cancer [odds ratio （OR）=4.137; 95% confidence interval （CI） 1.967 to 14.479）, disturbance of consciousness （OR=3.728;95%CI 1.313 to 8.315）, hypoalbuminemia （OR=2.960;95%CI 1.300 to 6.739）, hospital stay （OR=2.611; 95% CI 1.056 to 6.451）, performance status （OR=2.187; 95% CI 1.345 to 4.071）, diabetes mellitus （OR=1.937; 95% CI 1.159 to 3.238）, and chronic obstructive pulmonary disease （COPD;OR=1.823;95%CI 1.056 to 3.891） in this elderly cohort with terminal stage cancer （all P〈0.05）. Conclusion Pulmonary infection is common in the elderly patients with terminal stage cancer. Lung cancer, disturbance of consciousness, hypoalbuminemia, prolonged hospitalization, bedridden, and chronic comorbidity （diabetes mellitus and COPD） are risk factors for occurrence of pulmonary infection.