老年重症肺炎预后死亡的相关危险因素调查分析

Correlated risk factors investigation analysis on prognosis death of elderly patients with severe pneumonia

目的探讨老年重症肺炎预后死亡的相关危险因素，为临床诊治重症肺炎提供依据。方法回顾性收集129例老年重症肺炎资料，依据预后情况将患者分为存活组（95例）和死亡组（34例），采用单因素和多因素分别筛选影响预后死亡相关危险因素。结果老年重症肺炎的预后病死率为26．4％（34／129）；多因素分析结果显示基础疾病数（OR=2．259）、器官功能损害数（OR=3．435）、呼吸衰竭（OR=3．028）、APACHEII评分（OR=6．876）、使用呼吸机时间（OR=5．760）及酸中毒（OR=2．835）是老年重症肺炎预后死亡的危险因素。结论老年重症肺炎的预后病死率较高，影响其预后死亡的高危因素包括基础疾病数、器官功能损害数、有呼吸衰竭、APACHEII评分高、长期使用呼吸机及酸中毒。

Objective To explore correlated risk factors of prognosis death of the elderly with severe pneumonia, then to provide basis for diagnosis and treatment of severe pneumonia patients. Methods Data of 129 cases of the elderly with severe pneumonia were retrospectively collected, and according to prognosis condition of severe pneumonia, these cases were divided into survival group （95 cases） and death group （34 cases）. Then single factor and multiple factors analysis methods were used to analyze the risk factors of severe pneumonia of the elderly. Results The death rate of severe pneumonia of the elderly was 26.4% （34/129）. Multiple factors analysis result showed that the risk factors of severe pneumonia patients of the elderly includ- ed numbers of basic diseases （ OR = 2. 259 ）, numbers of injury of organs function （ R = 3. 435 ）, respiratory failure （ OR = 3. 028 ）, scores of APACHE II （ OR = 6. 876 ）, use time of respirator （ OR = 5. 760） and acidosis （ OR = 2. 835 ）. Conclusion The death rate of severe pneumonia of the elderly lies in a high level. These risk factors such as more basic diseases, more injury of organs function, respiratory failure, higher scores of APACHE II, long-term use of respirator and acidosis are independent risk factors of severe pneumonia of the elderly.