2型糖尿病尿路感染患者住院时长的影响因素研究

Study on influencing factors of length of stay for type 2 diabetes mellitus with urinary tract infection

目的探讨影响2型糖尿病尿路感染患者住院时长的相关因素,为临床护理提供参考。方法采用回顾性病例对照方法,选取山西省人民医院2019年1月至2020年9月228例确诊患有2型糖尿病尿路感染住院患者作为研究对象,按照患者住院时长进行分组,分为观察组79例和对照组149例,回顾性分析2组患者在内分泌科住院期间的电子病史资料以及相关实验室检查指标。对2组患者的一般人口学资料、疾病史、糖化血红蛋白等实验室指标进行统计学分析。结果影响患者住院时长的单因素分析显示,患者年龄、性别、医保支付方式、查尔森合并症指数(CCI)、治疗、糖化血红蛋白、降钙素原差异有统计学意义(χ^(2)值为5.107~20.134,t值为3.946,Z值为-2.914,P<0.05);Logistic回归分析显示,女性(OR=0.405,95%CI 0.172~0.951)、年龄≥70岁(OR=0.528,95%CI 0.303~0.922)、胰岛素治疗(OR=0.479,95%CI 0.269~0.854)、CCI≥3分(OR=2.555,95%CI 1.346~4.851)、支付方式中新农合(OR=0.273,95%CI 0.120~0.620)、居民医保(OR=0.184,95%CI 0.083~0.405)、其他(OR=0.367,95%CI 0.157~0.862)、降钙素原(OR=0.252,95%CI 0.290~0.877)、糖化血红蛋白(OR=0.81,95%CI 0.705~0.930)是2型糖尿病尿路感染住院患者住院时长的影响因素。结论女性、年龄≥70岁、胰岛素治疗、CCI≥3分、糖化血红蛋白和降钙素原增高的患者住院时间更长,与职工医保相比,新农合、居民医保、其他支付方式的患者住院时间更短,应当进一步提高临床检测能力,切实减轻患者痛苦和经济负担。

Objective To investigate the related factors of length of stay in type 2 diabetes mellitus(T2DM)with urinary tract infection,and provide reference for clinical nursing.Methods A retrospective analysis was used to collect patients′general demographic data,disease history,HbA1c,and other laboratory indicators,and etc.A total of 228 hospitalized patients with confirmed T2DM with urinary tract infection in Shanxi People′s Hospital from January 2019 to September 2020 were selected as the study subjects.The patients were divided into observation group(n=79)and control group(n=149)according to their length of stay.The electronic medical history and related laboratory examination indexes of the two groups during hospitalization in the Department of Endocrinology were analyzed retrospectively.The general demographic data,disease history,glycosylated hemoglobin and other laboratory indexes of the two groups were statistically analyzed.Results The results of single factor analysis on the influence of length of stay showed that there were statistically significant differences in age,gender,medicare payment method,Charlson Complication Index(CCI),treatment,glycosylated hemoglobin,procalcitonin(PCT)(χ^(2) values were from 5.107 to 20.134,t value was 3.946,Z value was-2.914,P<0.05).Logistic regression analysis showed that female(OR=0.405,95%CI 0.172-0.951),age≥70 years old(OR=0.528,95%CI 0.263-0.922),insulin treatment(OR=0.479,95%CI 0.269-0.854),CCI≥3 points(OR=2.555,95%CI 1.346-4.851),payment method of new rural cooperative medical insurance(OR=0.273,95%CI 0.120-0.620),resident medical insurance(OR=0.184,95%CI 0.083-0.405),others(OR=0.367,95%CI 0.157-0.862),PCT(OR=0.252,95%CI 0.290-0.877),and HbA1c(OR=0.81,95%CI 0.705-0.930)were the influencing factors for the length of stay in patients of T2DM with urinary tract infection.Conclusion Patients have a longer hospital stay in women,age≥70 years old,and insulin treatment,CCI≥3 points,HbA1c and PCT.Compared with the employee medical insurance,patients have a shorter hospital stay with new rural cooperative medical insurance,resident medical insurance and other payment methods.Therefore,clinical testing ability should be further improved to effectively reduce the pain and economic burden of patients.