老年患者术后医院感染的危险因素分析

Risk factors of postoperative nosocomial infections in elderly patients

目的调查老年住院患者术后医院感染的发病情况,分析其发生医院感染的危险因素。方法采用回顾性病例对照研究方法,对医院2016年老年住院手术患者7 084例进行横断面调查,其中术后感染225例,采集患者相关临床资料应用多因素logistic回归法,分析老年患者术后医院感染的危险因素。结果老年住院患者术后医院感染发病率为3.18%,医院感染部位以下呼吸道感染为主,占47.49%;logistic回归结果显示:高龄、术前住院天数长、曾住ICU、使用呼吸机、中心静脉置管、留置导尿、手术时间长、急诊手术、NNIS评分越高、ASA评分级别越高、术前外周血白细胞数越高、手术切口分类污染程度增加是老年患者术后发生医院感染的独立危险因素(P<0.05)。结论老年手术患者发生术后医院感染的危险因素较多,应针对危险因素进行早期干预,预防术后医院感染的发生,从而提高原发病的治愈率。

OBJECTIVE To investigate the incidence of postoperative nosocomial infections in elderly hospitalized patients,and analyze risk factors of nosocomial infections.METHODS We adopt retrospective cross-sectional study to investigate all the operations of 7084 cases of elderly hospitalized patients from Jan 2016 to Dec.2016 and collected the clinical data.The risk factors of postoperative nosocomial infection in elderly hospitalized patients were analyzed by multivariate logistic regression analysis.RESULTS The incidence of postoperative nosocomial infections in elderly hospitalized patients was 3.18%.The main infection site was lower respiratory tract infection,accounting for 47.49%.Logisticregression analysis showed that the old age,preoperative hospitalization days,once in ICU,using ventilator,CVC,urethral catheterization,long operation time,emergency operation,high NNIS and ASA scores,high number of white blood cells in the peripheral blood before operation,and increasing of classification degree of surgical incision were risk factors of postoperative nosocomial infections in elderly patients（P〈0.05）.CONCLUSION There are so many risk factors of postoperative nosocomial infections in elderly patients.We should apply early interventions according to risk factors to prevent the development of postoperative nosocomial infections,so as to improve the cure rate of primary disease.