长期住院老年患者医院内获得性肺炎的危险因素分析

Risk factors of hospital—acquired pneumonia in long—stay elderly patients

目的探讨长期住院老年患者医院内获得性肺炎(HAP)发病的危险因素,为降低老年患者HAP的发病率和病死率提供依据。方法回顾性分析2010-10—2013-10内科连续住院时间>90d的107例老年患者的临床资料,统计HAP发病率并分析相关危险因素。结果 (1)长期住院老年患者HAP的发病率为33.64%。(2)多因素logistic回归分析显示,留置胃管、活动受限、意识障碍、中枢神经系统疾病、使用抗菌药物、制酸剂、糖皮质激素、血浆白蛋白水平<35g/L是长期住院老年患者HAP发病的独立危险因素。结论长期住院老年患者HAP发病的独立危险因素众多,有效控制HAP的发生需要综合的防控措施。

Objective To investigate the risk factors of hospital- acquired pneumonia（HAP） in long- stay elderly patients. Methods The clinical data of 107 patients over 65y hospitalized for〉90d during October 2010 to October 2013 were retrospectively reviewed. Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression. Results HAP occurred in 36 out of 107 cases with a infection rate of 33.64%. Multivariable logistic regression analysis with backward method found that insertion of nasogastric tube, supine position, depressed level of consciousness, nervous system diseases, administration of antibiotics, glucocorticoid or antacid, albumin〈35g/L were independent risk factors of HAP in the elderly patients. Conclusion The risk factors of hospital- acquired pneumonia identified in this study may provide information of intervention measures for long- stay elderly patients.