慢性阻塞性肺疾病急性加重期住院患者在院死亡相关危险因素的回顾性分析

Retrospective Analysis of Risk Factors Related to Hospital Death in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者死亡危险因素,为AECOPD的防治工作提供参考依据。方法检索某院2012年1月1日-2019年12月31日所有出院患者中主要诊断为慢性阻塞性肺疾病急性加重的患者资料,以是否死亡为因变量,以性别、年龄及各种合并症为影响因素,进行二分类logistic回归分析。结果多因素二分类Logistic回归模型结果显示,年龄较大、APACHEⅡ评分≥20、有机械通气、呼吸衰竭、心力衰竭、慢性肾衰竭和高碳酸血症对AECOPD患者在院死亡的影响差异有统计学意义(P<0.05)。结论年龄较大、APACHEⅡ评分≥20、有机械通气、重要脏器的功能衰竭和高碳酸血症竭是AECOPD患者在院死亡的危险因素,需提早对这些危险因素进行有效的预防和控制,以改善AECOPD患者的不良预后。

Objective To analyze the risk factors of death in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD), so as to provide reference for the prevention and treatment of AECOPD. Methods The data of all discharged patients from a hospital from January 1, 2012 to December 31, 2019, who were diagnosed as AECOPD, were collected. The discharge condition(survival/death) was used as dependent variable, and gender, age and various complications were used as independent variables for binary logistic regression analysis. Results Older age, APACHEⅡ score≥ 20, mechanical ventilation, respiratory failure, heart failure, chronic renal failure, pleural effusion, hypoproteinemia and hypercapnia were the risk factors of hospital death in patients with acute exacerbation of COPD(P<0.05). Conclusion Age, Apache Ⅱ score≥20, mechanical ventilation, organ failure and hypercapnia exhaustion are the risk factors of AECOPD patients’ death in hospital. It is necessary to prevent and control these risk factors in advance to improve the adverse prognosis of AECOPD patients.