高龄骨折患者并发院内感染的危险因素分析

Risk factors analysis of nosocomial infection of elderly fractura patients

目的探讨高龄骨折患者并发院内感染的危险因素。方法选取攀枝花市仁和区人民医院2012年10月—2016年5月收治的高龄骨折患者198例,收集分析患者的住院时间(<2周、2~3周及>3周)、年龄(<75岁及≥75岁)、抗生素应用时间(<1周及≥1周)、合并基础疾病(是,否)及手术时间(≤2 h及>2 h),分析高龄骨折患者并发院内感染的危险因素。结果 198例患者中,出现院内感染20例,包括呼吸道感染10例,创口感染6例,泌尿道感染3例,消化道感染1例,将所有患者分为感染组(n=20)和未感染组(n=178),两组患者性别比较,差异无统计学意义(P>0.05);感染组患者年龄、住院时间、抗生素应用时间、合并基础疾病及手术时间与未感染组比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,年龄[OR=3.106,95%CI(1.515,8.758)]、住院时间[OR=2.452,95%CI(1.208,6.415)]、抗生素应用时间[OR=2.875,95%CI(1.376,7.763)]、合并基础疾病[OR=4.186,95%CI(2.054,16.350)]及手术时间[OR=3.241,95%CI(1.642,15.246)]是高龄骨折患者并发院内感染的危险因素(P<0.05)。结论年龄、住院时间、抗生素应用时间、合并基础疾病及手术时间是高龄骨折患者并发院内感染的危险因素,且感染以呼吸道感染为主。

Objective To discuss the risk factors of nosocomial infection of elderly fractura patients. Methods A total of 198 elderly patients with fractura were selected from October 2012 to May 2016 in Renhe District People＇s Hospital of Panzhihua, the hospitalization time （ 〈 2 weeks, 2 - 3 weeks and 〉 3 weeks）, ages （ 〈 75, ≥75）, application time of antibiotics （ 〈 1 week, ≥ 1 week）, basic disease （yes or no） .and operative time （ ≤2 h, 〉 2 h） Were collected, and the ：risk factors of nosocomial infection.of elderly fractura patients were analyzed. Results In 198 cases of elderlypatients with fractnra, 20 cases had nosocomial infection, wound infection had 6 cases, urinary tract bacterial infections had 3 eases, digestive tract infection had ! case, no significant difference of gender was found between the two groups （ P 〉 0. 05 ） ; the hospitalization time, ages, application time of antibiotics, basic disease and operative time of infection group were worse than non - infection （P 〈0. 05）. Multivariate logistic showed that ages [OR = 3. 106, 95% CI （ 1. 515, 8. 758） ], hospitalization time [ OR = 2. 452, 95% CI （ 1. 208, 6. 415 ） ], application time of antibiotics [ OR = 2. 875, 95% CI （ 1. 376, 7. 763 ） ], basic disease [OR =4. 186, 95%CI （2. 054, 16. 350） ] and operative time [OR =3. 241, 95% CI （ 1. 642,15. 246） ] were the risk factors of nosocomial infection of elderly fractura patients （P 〈 0. 05 ）. Conclusion Age, hospitalization time, application time of antibiotics, basic disease and operative time were the risk factors of nosocomial infection of elderly fractura patients, and the respiratory infection is the main factor of infection.