老年患者急性胆道感染相关危险因素分析

The risk factors for acute biliary tract infection in the elderly patients

目的探讨急诊科病房老年患者急性胆道感染的相关危险因素,为预防老年急性胆道感染和降低病死率提供科学依据。方法回顾性分析比较上海市静安区中心医院急诊科病房2016年1月-2018年12月82例老年急性胆道感染病例和54例老年胆道疾病未感染病例。采用单因素分析和多因素logistic回归分析其相关危险因素。将三年间急诊科出院所有患者数据导入Excel 2007,运用STATA 7.0统计软件对筛选出的136例老年胆道疾病患者进行描述性分析和危险因素logistic回归分析。结果多因素logistic回归分析发现,营养风险筛查量表(NRS 2002)评分高、低白蛋白血症、合并多种基础疾病是急诊科病房老年患者急性胆道感染的独立危险因素。对82例老年急性胆道感染组患者(死亡24例,生存58例)的多因素logistic回归分析发现,低白蛋白血症和NRS 2002评分升高是影响预后的独立危险因素。结论急诊科病房伴有NRS 2002评分升高、低白蛋白血症以及合并多种基础疾病的老年患者易发生急性胆道感染,治疗难度大。NRS 2002评分升高及低白蛋白血症是影响老年急性胆道感染预后的独立危险因素。可以此作为临床干预指标预防老年急性胆道感染。

Objective To investigate the risk factors for acute biliary tract infection in the elderly patients admitted to emergency room and provide evidence for preventing the attack of acute biliary tract infection and lowering the mortality of such patients.Methods A retrospective analysis was conducted to compare the clinical data between 82 cases of acute biliary tract infection and 54 cases of stable biliary tract disease in the elderly patients admitted to Emergency Room of Jing'an District Centre Hospital of Shanghai during the period from January 2016 through December 2018.Univariate analysis and multivariate logistic regression analysis were carried out to identify the risk factors for incidence of acute biliary tract infection.Results Multivariate logistic regression analysis showed that high 2002 nutrition risk screening(NRS 2002)score,hypoalbuminemia,and underlying disease were independent risk factors for occurrence of acute biliary tract infection in the elderly patients admitted to emergency room.Multivariate logistic regression analysis of the 82 cases of acute biliary tract infection(24 died,58 survivors)revealed that hypoalbuminemia and high 2002 NRS score were independent predictors of death.Conclusions The elderly patients admitted to emergency room with high NRS 2002 score,hypoalbuminemia,and/or underlying disease are prone to acute biliary tract infection.High NRS 2002 score and hypoalbuminemia are risk factors predicting death of elderly patients with acute biliary tract infection.