老年肺部感染住院患者预后影响因素分析

Analysis of prognostic factors in elderly hospitalized patients with pulmonary infection

目的探讨老年肺部感染住院患者预后的影响因素,为其临床诊疗提供参考依据。方法回顾性分析2016年1月至2018年12月在解放军联勤保障部队第980医院住院的207例老年肺部感染患者的临床资料,收集患者住院时的性别、年龄、白蛋白、N末端脑纳肽、D-二聚体、降钙素原、乳酸等临床资料,根据患者预后分为存活组(n=169)和死亡组(n=38),采用单因素分析及Logistic回归多因素分析老年肺部感染患者预后的影响因素。结果存活组患者的年龄、N末端脑纳肽、降钙素原、乳酸低于死亡组,白蛋白高于死亡组,差异均具有统计学意义(P<0.05);将上述5个因素进行Logistic回归多因素分析,结果显示低白蛋白、高龄、高乳酸是影响老年肺部感染患者预后的独立危险因素(P<0.05)。结论老年肺部感染患者病情复杂,临床预后受多种因素影响,其中年龄>80岁、乳酸>2.5 mmol/L、白蛋白≤30 g/L是影响预后的独立危险因素。

Objective To explore the prognostic factors of elderly patients with pulmonary infection in hospital, and to provide reference for clinical diagnosis and treatment. Methods The clinical data of 207 elderly patients with pulmonary infection admitted to the 980 th Hospital of Joint Logistics Support Force of PLA from January 2016 to December 2018, including sex, age, albumin, N-terminal brain natriuretic peptide, D-dimer, procalcitonin, and lactic acid, were collected and retrospectively analyzed. The patients were divided into survival group(n=169) and death group(n=38). The factors influencing the prognosis of elderly patients with pulmonary infection were analyzed by univariate analysis and logistic regression analysis. Results The age, N-terminal brain natriuretic peptide, procalcitonin, and lactate acid of the survival group were lower than those of the death group, and the differences were statistically significant(P<0.05). The albumin of the survival group was higher than that of the death group, and the difference was statistically significant(P<0.05). Logistic regression analysis of the above five factors showed that low albumin, old age, and high lactic acid were independent risk factors affecting the prognosis of elderly patients with pulmonary infection(P<0.05).Conclusion The clinical prognosis of elderly patients with pulmonary infection is influenced by many factors, among which age>80 years, lactic acid>2.5 mmol/L, and albumin ≤30 g/L are independent risk factors.