老年慢性胃炎合并上消化道出血住院患者医院感染的危险因素

Risk factors for nosocomial infection in elderly hospitalized patients with chronic gastritis complicated with upper gastrointestinal bleeding

目的分析老年慢性胃炎合并上消化道出血(Upper gastrointestinal bleeding,UGIB)住院患者医院感染危险因素及预后。方法选择2017年1月-2019年3月焦作市人民医院收治的108例老年慢性胃炎合并UGIB患者为研究对象,收集患者临床资料,单因素和多因素Logistic回归模型分析老年慢性胃炎合并UGIB患者医院感染的危险因素及预后情况。结果108例老年慢性胃炎合并UGIB患者中,医院感染发生率25.93%(28/108),以呼吸道感染为主,占60.71%(17/28),多因素Logistic回归分析结果,年龄≥70岁(OR=3.347,95%CI:1.586~7.062),住院时间长(OR=1.369,95%CI:1.080~1.735),合并糖尿病(OR=2.656,95%CI:1.419~4.974)和侵入性止血方式(OR=4.080,95%CI:1.729~9.626)是老年慢性胃炎合并UGIB住院患者发生医院感染的独立危险因素(均P<0.05);感染组病死率和再出血率均显著高于未感染组(10.71 vs.1.25%;14.29%vs.2.50%),差异均有统计学意义(χ~2=5.209、5.491,均P<0.001)。结论老年慢性胃炎合并UGIB住院患者医院感染率高;高龄、住院时间长、合并糖尿病以及侵入性止血方式是医院感染的独立危险因素,应积极针对上述危险因素进行针对性预防,以改善患者预后,减少病死率和再出血率。

OBJECTIVE To investigate the risk factors for nosocomial infection in elderly hospitalized patients with chronic gastritis complicated with upper gastrointestinal bleeding(UGIB)and observe the prognosis.METHODS A total of 108 elderly patients with chronic gastritis complicated with UGIB who were treated in Jiaozuo People′s Hospital from Jan 2017 to Mar 2019 were recruited as the study objects,the clinical data were collected from the patients,univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the nosocomial infection in the elderly patients with chronic gastritis complicated with UGIB,and the prognosis was observed.RESULTS Of the 108 elderly patients with chronic gastritis complicated with UGIB,25.93%(28/108)had nosocomial infection,60.71%(17/28)of whom had respiratory tract infection.The result of multivariate logistic regression analysis showed that no less than 70 years of age(OR=3.347,95%CI:1.586-7.062),long length of hospital stay(OR=1.369,95%CI:1.080-1.735),complication with diabetes mellitus(OR=2.656,95%CI:1.419-4.974)and invasive hemostasis(OR=4.080,95%CI:1.729-9.626)were the independent risk factors for nosocomial infection in the elderly hospitalized patients with chronic gastritis complicated with UGLB(all P<0.05).The mortality rate of the infection group was 10.71%,significantly higher than 1.25%of the non-infection group;the recurrent bleeding rate of the infection group was 14.29%,significantly higher than 2.50%of the non-infection group(χ~2=5.209,5.491,all P<0.001).CONCLUSION The incidence rate of nosocomial infection is high among the elderly hospitalized patients with chronic gastritis complicated with UGIB.The advanced age,long length of hospital stay,complication with diabetes mellitus and invasive hemostasis are the independent risk factors for the nosocomial infection.It is necessary to take targeted prevention measures according to the above risk factors so as to improve the prognosis and reduce the recurrent bleeding rate and mortality rate.