老年患者院内感染影响多因素Logistic分析及营养干预研究

Multivariate logistic analysis of the influencing factors of nosocomial infection in elderly patients and the study of nutritional intervention

目的:探讨老年患者院内感染影响多因素Logistic分析及营养干预的作用效果。方法:根据患者是否发生院内感染,将800例老年患者分为感染组( n=24)与非感染组(n =776)。两组入院后均行相关检查,查阅病历资料,统计并记录患者性别、年龄、住院时间、是否存在入侵式操作、是否使用抗生素、是否利用免疫调节剂及激素、季节等,对上述影响因素进行多因素Logistic分析,对于感染患者给予营养干预。结果: 800例老年住院患者中,院内感染24例,感染率为3.0%。感染部位排在前3位的分别为下呼吸道感染、尿路感染与消化系统感染,分别占50.00%、25.00%及12.50%。单因素及多因素Logistic分析结果表明:老年患者院内感染率与性别不相关( P>0.05);老年患者院内感染率与年龄、住院时间、是否存在入侵式操作、是否使用抗生素、是否利用免疫调节剂及激素、糖尿病、营养不良、季节相关(P <0.05)。结论:老年患者院内感染率较高,且影响因素相对较多,不同因素能相互作用、相互影响;根据危险因素加强患者营养干预有助于降低院内感染率。

Objective: To explore the multivariate logistic analysis of the influencing factors of nosocomial infection in elderly patients and the study of nutritional Intervention. Methods: A total of 800 elderly patients were enrolled and divided into the infection group( n =24) and the non-infected group ( n =776).After admission,the patients in the two groups were examined and the medical records were consulted.The gender,age,length of stay,invasive operation,antibiotic use,immunomodulator and hormone use,season and so on were counted and recorded.Multivariate logistic analysis was carried out to analyze the above influencing factors,and nutrition intervention was given to the infected patients. Results: Of 800 elderly inpatients,24 were nosocomial infections,the infection rate was 3.0 %.The top three infection sites were lower respiratory tract infection,urinary tract infection and digestive tract infection,accounting for 50.00 %,25.00 % and 12.50 %,respectively.Single factor and multivariate logistic analysis showed that there was no correlation between nosocomial infection rate and gender in elderly patients( P >0.05).The nosocomial infection rate of elderly patients was correlated with age,length of stay,invasive operation,antibiotic use,immunomodulator and hormone use,diabetes mellitus,malnutrition and season( P <0.05). Conclusion: The nosocomial infection rate of elderly patients is high,and there are relatively many influencing factors.Different factors can interact and influence each other.Strengthening nutritional intervention according to risk factors can help reduce nosocomial infection rate.