80岁以上老年肺部感染并发多器官功能不全死亡的影响因素研究

Influence factors of death of MODSE induced by pulmonary infection in the patients aged above 80 years old

目的探讨>80岁老年患者肺部感染并发多器官功能不全综合征(MODSE)死亡的影响因素。方法对2006年1月至2013年12月在我院住院的97例>80岁肺部感染并发MODSE病例进行回顾性研究,分析所患慢性疾病、MODSE临床分期、受损器官数量及各受损器官对死亡的影响。结果单因素分析显示,各慢性疾病与MODSE死亡无关联(P>0.05);MODSE衰竭期患者死亡率明显高于MODSE衰竭前期患者(χ2=37.168,P<0.01);病例的受损器官数量与MODSE死亡率呈正相关(r=0.488,P<0.01);在各受损器官中,外周循环受损患者死亡率明显高于未受损患者(χ2=11.581,P=0.001)。多因素Logistic回归分析显示,MODSE临床分期(P<0.01)和受损器官数量(P=0.022)为MODSE死亡的独立危险因素。结论 MODSE临床分期和受损器官数量是>80岁老年肺部感染并发MODSE死亡的独立影响因素。

Objective To explore the influence factors of death of myltiple myltiple organ dysfunction syndrom in the elderly（ MODSE） induced by pulmonary infection in the patients aged above 80 years old. Methods Ninety-seven cases aged 80 years and over with MODSE induced by pulmonary infection were enrolled from January 2006 to September 2013. The chronic diseases,clinical stage of MODSE and damaged organs of all cases were analyzed. Results Single factor analysis showed that the chronic diseases were not risk factors for MODSE death（ P〉 0. 05）. The mortality rate of patients in the failure stage was significantly higher than that in early failure stage（ χ2= 37. 168,P〈0. 01）. The number of damaged organs was positively correlated with the morbidity of MODSE（ r = 0. 488,P〈0. 01）. The mortality rate of patients whose peripheral circulation were damaged,and it was higher than that of cases whose peripheral circulation were not damaged（ χ2= 11. 581,P = 0. 001）. Binary Logistic regression analysis showed that the clinical stage of MODSE and the number of damaged organs were the risk factors of MODSE death. Conclusions The clinical stage of MODSE and the number of damaged organs are independent risk factors of death of MODSE induced by pulmonary infection in the patients aged 80 years and over.