社区获得性肺炎住院患者死亡的预测因素分析

Analysis of Death Factors in Hospitalized Patients with Community-acquired Pneumonia

目的:调查影响社区获得性肺炎住院患者死亡的预测因素。方法:本研究回顾性分析2015年1月-2017年1月于笔者所在医院住院治疗的597例社区获得性肺炎患者临床资料。包括年龄、性别、慢性阻塞性肺疾病、恶性肿瘤等。根据30 d内是否发生死亡将患者分为死亡组(36例)和未死亡组(561例)。进行单因素分析及多因素Logistic回归分析影响社区获得性肺炎住院患者死亡的因素。结果:单因素分析显示,年龄、慢性阻塞性肺疾病、恶性肿瘤、氧合指数≤250 mm Hg、低白蛋白血症、高尿素氮血症、肌酐>133μmol/L、C反应蛋白>10 mg/L、多叶肺炎、菌血症、机械通气和使用血管活性药物与社区获得性肺炎住院患者死亡有关(P<0.05)。多因素Logistic回归分析显示,年龄、慢性阻塞性肺疾病、恶性肿瘤、氧合指数≤250 mm Hg、低白蛋白血症、高尿素氮血症和机械通气是影响社区获得性肺炎住院患者死亡的独立预测因素(P<0.05)。结论:年龄、慢性阻塞性肺疾病、恶性肿瘤、氧合指数≤250 mm Hg、低白蛋白血症、高尿素氮血症和机械通气是影响社区获得性肺炎住院患者死亡的危险因素。

Objective:To investigate the death factors in hospitalized patients with community-acquired pneumonia.Method:This study retrospectively analyzed the clinical data of 597 community-acquired pneumonia patients hospitalized in our hospital from January 2015 to January 2017.This includes age,sex,chronic obstructive pulmonary disease,malignancy.According to whether death occurred within 30 days,they were divided into the death group(36 case)and the non-death group(561 case).Univariate analysis and multivariate logistic regression analysis were performed on the factors affecting the death of hospitalized patients with community-acquired pneumonia.Result:Univariate analysis showed that age,chronic obstructive pulmonary disease,malignancy,oxygenation index≤250 mm Hg,hypoalbuminemia,hyperureantaemia,creatinine>133μmol/L,C-reactive protein>10 mg/L,multi-lobular pneumonia,bacteremia,mechanical ventilation and use of vasoactive drugs were associated with the death of hospitalized patients with community-acquired pneumonia(P<0.05).Multivariate logistic regression analysis showed that age,chronic obstructive pulmonary disease,malignancy,oxygenation index≤250 mm Hg,hypoalbuminemia,hyperureanazaemia,and mechanical ventilation were independent predictors of death in hospitalized patients with community-acquired pneumonia(P<0.05).Conclusion:Age,chronic obstructive pulmonary disease,malignancy,oxygenation index≤250 mm Hg,hypoalbuminemia,hyperureanazaemia and mechanical ventilation are risk factors that affected the death of hospitalized patients with community-acquired pneumonia.