入住 EICU 的高龄重症肺炎患者院内死亡的危险因素分析

Risk factors of in-hospital mortality of old severe pneumonia patients admitted to EICU

目的：研究影响入住急诊重症监护室（EICU）的高龄（〉65岁）重症肺炎患者院内死亡的危险因素。方法回顾性纳入2015年1月1日至5月31日因重症肺炎入住我院 EICU 的高龄患者，统计其院内病死率，同时收集相关临床资料，对病死率产生影响的因素进行分析。结果共纳入了30例重症肺炎患者，平均年龄（81.77±7.78）岁，其中男性19例，平均年龄（79.53±7.25）岁。死亡12人，其中男性8例，平均年龄（81.17±10.20）岁。患者性别、是否全身应用糖皮质激素、近3个月内是否住院治疗以及是否应用机械通气、气管镜治疗、急性生理与慢性健康评分（APACHE Ⅱ评分）与死亡无关，入院时动脉血气分析（ABG）中血乳酸水平以及入院时呼吸频率与院内病死率相关，进一步的多因素分析提示上述指标均不是重症肺炎患者 EICU 院内死亡的独立危险因素。结论动脉血乳酸水平以及入院时呼吸频率与入住 EICU 的重症肺炎患者院内死亡有关，但不是其独立危险因素。

Objective To investigate the risk factors of in-hospital mortality in old severe pneumonia patients admitted to EICU.Methods Severe pneumonia patients older than 65 years who were admitted to EICU from 1st January 201 5 to 31st May were retrospectively enrolled.The in-hospital mortality and associated clinical data were collected and analysised.Results 30 patients were finally enrolled with age of（81.77±7.78） years,1 9 patients were male and 12 patients died in hospital.The in-hospital mortality was not associated with gender,glucortical therapy usage,repeated hospitalization in 3 months,ventilator therapy,sputum suction by bronchoscope,acute physiology and chronic health evaluation（APACHE Ⅱ） score but with the concentration of lactate in artery and the respiration rate on admission.Further logistic analysis revealed that the artery lactate concentration and respiration rate on admission was not the independent risk factors of in the in-hospital mortality in EICU.Conclusions The artery lactate concentration and respiration rate on admission is associated with the in-hospital mortality in severe pneumonia patients admitted to EICU.