老年吸入性肺炎的危险因素分析及风险预测模型构建

Analysis of aspiration pneumonia risk factors in elderly patients and risk prediction model construction

目的探讨老年吸入性肺炎的危险因素,建立风险预测模型,以期降低老年吸入性肺炎的发病率。方法选取2017年8月28日—2020年10月30日广州市第一人民医院老年病科住院治疗的老年肺炎患者205例,按照是否发生吸入性肺炎分为吸入性肺炎组和非吸入性肺炎组,对比2组患者的各项指标,分析老年吸入性肺炎的危险因素,建立风险预测模型,采用ROC曲线对模型进行预测效果检验。结果多因素Logistic回归分析结果显示,脑梗塞、帕金森、留置胃管、长期卧床为老年吸入性肺炎的危险因素(P<0.05)。模型公式为Logit(P)=-2.952+1.221X_(2)+2.417X_(3)+2.388X_(8)+1.683X_(10)。该模型ROC曲线下面积为0.894。结论本研究中的模型预测效果良好,可为医护人员预测老年患者发生吸入性肺炎的概率,及时采取相应的预见性护理及干预性治疗。

Objective To explore the risk factors of aspiration pneumonia in the elderly and establish the risk prediction model,in order to reduce the incidence of aspiration pneumonia in the elderly.Methods A total of 205 elderly patients with pneumonia who were hospitalized in the department of geriatrics,Guangzhou First People's Hospital from August 28,2017 to October 30,2020,were divided into aspiration pneumonia group and non-aspiration pneumonia group according to whether aspiration pneumonia occurred.The indicators of the two groups of patients were compared,the risk factors of aspiration pneumonia in the elderly were analyzed,the risk prediction model was established,and the prediction effect of the model was tested by receiver operating characteristic curve.Results Multivariate Logistic regression analysis showed that cerebral infarction,Parkinson's disease,indwelling nasogastric tube,and being bedridden were risk factors for aspiration pneumonia in elderly patients(P<0.05).The model formula was Logit(P)=-2.952+1.221X_(2)+2.417X_(3)+2.388X_(8)+1.683X_(10).The area under receiver operating characteristic curve of this model was 0.894.Conclusion The prediction effect of the model in this study was good,which could predict the probability of aspiration pneumonia in elderly patients for medical staff,and to timely take the corresponding predictive care and interventional treatment.