心脏重症监护室多重耐药菌感染患者预后的影响因素分析

Analysis of influence factors for prognostic of patients with multidrug-resistant bacteria infection in cardiac care unit

目的探讨影响心脏重症监护室(ICU)多重耐药菌感染患者预后的影响因素,针对危险因素探讨护理方针。方法选取2017年2月至2021年7月鹰潭市人民医院心脏外科ICU收治的多重耐药菌感染患者作为研究对象,根据治疗28 d时临床结局将其分为存活组(n=70)及死亡组(n=28),比较患者临床资料,采用logistic回归分析预后的影响因素。结果共98例患者被纳入研究,单因素结果提示,存活组及死亡组患者年龄、急性生理及慢性健康评分Ⅱ(APACHEⅡ)、白蛋白水平比较,差异有统计学意义(P<0.05);多因素结果分析提示,APACHEⅡ(β=0.124,OR=1.132,95%CI=1.101~1.164)是心脏外科ICU多重耐药菌感染患者预后不良的独立危险因素,白蛋白水平(β=-0.145,OR=0.865,95%CI=0.819~0.914)是心脏外科ICU多重耐药菌感染患者预后不良的的独立保护因素(P<0.05)。结论心脏外科ICU多重耐药菌感染患者病死率高,入ICU时病情程度及白蛋白等指标水平与预后不良密切相关,在临床护理方面宜早期评估患者危重程度,进行风险分级管理,密切监测病情并及时处理。

Objective To investigate the factors influencing the prognosis of patients with multidrug-resistant bacteria infection in cardiac intensive care unit(ICU),and develop a nursing plan according to the risk factors.Methods Patients with multidrug-resistant bacteria infection who were admitted to cardiac ICU of Yingtan People′s Hospital from February 2017 to July 2021 were selected as the research subjects.They were divided into survival group((n=70))and death group(n=28)according to the clinical outcome after 28 days of treatment.The data of survival group and death group was comparatively analyzed.logistic regression analysis was performed to screen the prognostic factors.Results A total of 98 patients were included in the study.There were statistically significant differences between survival group and death group in age,acute physiology and chronic health scoreⅡ(APACHEⅡ)and albumin level(P<0.05).Multivariate analysis found that APACHEⅡ(β=0.124,OR=1.132,95%CI=1.101-1.164)was an independent risk factor for poor prognosis in patients with multidrug-resistant infection in cardiac surgery ICU,albumin level(β=-0.145,OR=0.865,95%CI=0.819-0.914)was an independent protective factor for poor prognosis in patients with multidrug-resistant bacterial infection in cardiac surgery ICU(P<0.05).Conclusion Patients with multidrug-resistant bacteria infection in cardiac ICU have a high mortality rate.The severity of the disease and albumin level at admission are closely related to poor prognosis.For clinical nursing,it is advisable to assess the severity of the disease early,carry out risk grading management,closely monitor the patient′s condition and deal with it in time.