Analysis of clinical characteristics and risk factors between elderly patients with severe and nonsevere Omicron variant infection

BACKGROUND Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has led to millions of confirmed cases and deaths worldwide.Elderly patients are at high risk of developing and dying from COVID-19 due to advanced age,decreased immune function,intense inflammatory response,and comorbidities.Shanghai has experienced a wave of infection with Omicron,a new variant of SARS-CoV-2,since March 2022.There is a pressing need to identify clinical features and risk factors for disease progression among elderly patients with Omicron infection to provide solid evidence for clinical policy-makers,public health officials,researchers,and the general public.AIM To investigate clinical characteristic differences and risk factors between elderly patients with severe and nonsevere Omicron SARS-CoV-2 variant infection.METHODS A total of 328 elderly patients with COVID-19 admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2022 to June 2022 were enrolled and divided into a severe group(82 patients)and a nonsevere group(246 patients)according to the diagnosis and treatment protocol of COVID-19(version 7).The clinical data and laboratory results of both groups were collected and compared.A chi-square test,t test,Mann-Whitney U test,hierarchical log-rank test,univariate and multivariate logistic regression,and hierarchical analyses were used to determine significant differences.RESULTS The severe group was older(84 vs 74 years,P<0.001),included more males(57.3%vs 43.9%,P=0.037),had a lower vaccination rate(P<0.001),and had a higher proportion of comorbidities,including chronic respiratory disease(P=0.001),cerebral infarction(P<0.001),chronic kidney disease(P=0.002),and neurodegenerative disease(P<0.001),than the nonsevere group.In addition,severe disease patients had a higher inflammatory index(P<0.001),greater need for symptomatic treatment(P<0.001),longer hospital stay(P=0.011),extended viral shedding time(P=0.014),and higher mortality than nonsevere disease patients(P<0.001).No difference was observed in the application of Paxlovid in the severe and nonsevere groups(P=0.817).Oxygen saturation,cerebral infarction,and D-dimer were predictive factors for developing severe disease in patients with COVID-19,with D-dimer having an excellent role(area under the curve:90.1%,95%CI:86.1-94.0%).In addition,D-dimer was a risk factor for developing severe COVID-19 according to multivariate stratified analysis.CONCLUSION The clinical course of severe COVID-19 is complex,with a higher need for symptomatic treatment.D-dimer is a suitable biomarker for identifying patients at risk for developing severe COVID-19.

Outcome and risk factors of ulcer healing after gastric endoscopic submucosal dissection: A systematic review and meta-analysis

BACKGROUND Endoscopic submucosal dissection(ESD)is widely utilized for the treatment of large adenomas,submucosal lesions,and early gastric cancer.A significant arti-ficial ulcer typically forms after ESD.Delayed or incomplete healing of these ulcers can result in complications such as delayed bleeding and perforation.However,a comprehensive review of the outcomes and risk factors related to ulcer healing following ESD is currently lacking.AIM To assess ulcer healing outcomes and identify risk factors associated with delayed ulcer healing.RESULTS Our analysis included 12 studies,involving a total of 3430 patients.The meta-analysis revealed an overall healing rate of 65.55%for ulcers following ESD[odds ratio(OR)=2.71;95%confidence interval(CI):2.45-3.00].The healing rate within eight weeks was 48.32%(OR=0.76;95%CI:0.35-1.66),while the rate beyond eight weeks was 88.32%(OR=6.73;95%CI:3.82-11.87).Risk factors included Helicobacter pylori(H.pylori)infection(OR:=5.32;95%CI:1.90-14.87;P=0.001),ulcer size(OR=2.08;95%CI:1.19-3.61;P=0.01),lesion site(OR=2.08;95%CI:1.19-3.11),and pathological type(OR=1.64;95%CI:1.06-2.52).Diabetes(OR=0.56;95%CI:0.05-5.80;P=0.63)and duration of operation(OR=1.00;95%CI:0.99-1.01;P=0.96)were not significant factors.CONCLUSION The healing rate of ulcers following ESD is high after eight weeks.Risk factors affecting the healing process include H.pylori infection,ulcer size,lesion site,and pathological type.

H pylori infection and other risk factors associated with peptic ulcers in Turkish patients: A retrospective study

AIM: To identify and evaluate the relative impact of H pylori infection and other risk factors on the occurrence of gastric ulcer (GU), duodenal ulcer (DU) and gastritis in Turkish patients. METHODS: A total of 4471 patients (48.3% female) out of 4863 attended the Samatya hospital in Istanbul (June 1999 - October 2003) were included. The records of H pylori status (CLO-test), endoscopic f indings of GU, DU and gastritis, personal habits (smoking, alcohol intake) and medication [non-steroidal anti-inflammatory drugs (NSAIDs), aspirin intake] were analyzed using multi-way frequency analysis. RESULTS: We have found that GU in the presence of H pylori had significant association with aspirin (P = 0.0001), alcohol (P = 0.0090) and NSAIDs (P = 0.0372). DU on the other hand had significant association with aspirin/ smoking/NSAIDs (P = 0.0259), aspirin/alcohol (P = 0.0002) and aspirin/smoking (P = 0.0233), also in the presence of H pylori. In the absence of H pylori GU had significant association with alcohol/NSAIDs (P = 0.0431), and NSAIDs (P = 0.0436). While DU in the absence of H pylori had significant association with smoking/alcohol/ NSAIDs (P = 0.0013), aspirin/NSAIDs (P = 0.0334), aspirin/alcohol (P = 0.0360). CONCLUSION: In the presence of H pylori, aspirin, alcohol and NSAIDs intake act as an independent risk factors that had an augmenting impact on the occurrence of GU and only together on the occurrence of DU in Turkish patients.

Pressure Ulcers in Institutionalized Elderly People:Association of Sociodemographic and Clinical Characteristics and Risk Factors

Objective: To evaluate the association of socio-demographic and clinical characteristics, and risk factors with occurrence of pressure ulcers in institutionalized elderly people. Method: This cross-sectional, analytical study, in quantitative approach, performed from the database analysis linked to the project “Pressure Ulcer in institutionalized elderly people: Association of incidence with the risk factors to functional and nutritional assessment” developed in six long-stay institutions for the elderly people in Jo&atildeo Pessoa. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Associations were made through chi square test and Odds Ratio. Results: The clinical conditions of significant associations with the occurrence of pressure ulcers were the variables neurological disorders (p = 0.011) and visual impairment (p = 0.005). As for risk factors, the most important was fecal incontinence (p Conclusion: The analysis of the associations pointed out problems that require intervention in order to prevent health implications of the elderly people and to minimize the risk and occurrence of this injury.

Prevalence and Risk Factors of Postoperative Pressure Ulcers:A Systematic Review and Meta-analysis of Diagnostic Test

[Objectives]The paper was to analyze the total prevalence of postoperative pressure ulcers in patients and to reveal the epidemic law.[Methods]By searching English databases such as PubMed,Google Academics,Scopus,Science Direct and Web of Science(WOS),a total of 2018 English articles on pressure ulcers published from January 2015 to December 2020 were selected.According to the inclusion criteria,19 high-quality literatures were selected for the study,and the extended function of meta-analysis software of Review Manager 5.1 diagnostic test was used for data statistics and meta analysis of the results.[Results]There were 19 literatures with a total of 9400 patients included in the meta-analysis.The results showed that the total prevalence estimate of postoperative pressure ulcers was 20.00%(CI 95%:15.3-24.1).The total prevalence estimate of postoperative pressure ulcers in males was 10.1%(CI 95%:7.2-13.02),and that in females was 12.8%(CI 95%:8.1-17.3).The total prevalence estimates of stage I to IV postoperative pressure ulcers were 17.02%(CI 95%:11.06-22.09),6.7%(CI 95%:3.76-9.69),0.9%(CI 95%:0.21-1.26)and 0.4%(CI 95%:-0.05-0.8),respectively.[Conclusions]The prevalence of postoperative pressure ulcers is generally high.The prevalence of postoperative pressure ulcers in females is higher than that in males,and the prevalence of stage I pressure ulcers is higher than that of other stages,which is related to age,gender and other related risk factors.

CAS-Complications Rate and Relation to Risk Factors

Purpose: The aim of the study was to evaluate the risk factors for CAS with cerebral protection and the incidence of complication in patients with severe carotid stenosis. Materials and Methods: Overall, 95 consecutive patients with an average age of 64.67 years (28 - 83) (16 women (17%) and 79 men (83%)) were enrolled in the prospective monocentric study. Indication for CAS was symptomatic carotid stenosis ≥70% (n = 60 (63.16%)) or asymptomatic stenosis ≥80% (n = 35 (36.84%)) according to the NASCET criteria on DSA, which were not suitable for surgery. Results: From the selected risk factors, the most frequently found were arterial hypertension in 87 patients (91.6%), ischemic heart disease in 70 (73.7%), hyperlipidemia in 61 (64.2%), history of stroke in 43 (45.3%), diabetes mellitus in 35 (36.8%), smoking in 13 (13.7%), and age more than 75 years in 9 (9.5%). Significantly more frequent complications in elderly patients (more than the age of 75 years) were experienced: TIA (p = 0.049), early death (p = 0.049), restenosis (p = 0.04), and overall mortality (p = 0.04). Conclusion: Among the studied risk factors, only patients more than the age of 75 years were affected by the incidence of serious complications.

A phase Ⅳ study of homoharringtonine, cytarabine, aclacinomycin and G-CSF(HCAG) regimen compared with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia patients

Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one patients with AML(aged 55-71 years) were randomly divided into two groups(Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival(RFS). Results · A total of 29 patients(70.7%) achieved complete remission(CR). The estimated 2-year overall survival(OS) was 66.8% in Group HCAG and 75.4% in Group IA(P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA(P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.

Dyslipidemia： evidence of efficacy of the pharmacological and non-pharmacological treatment in the elderly

The clinical decision to control risk factors for cardiovascular disease （CVD） in the elderly takes the followings into consideration： （1） the elderly life expectancy; （2） the elderly biological age and functional capacity; （3） the role of cardiovascular disease in the elderly group; （4） the prevalence of risk factors in the elderly; and （5） The effectiveness of treatment of risk factors in the elderly. A large number of studies showed the efficacy of secondary and primary prevention of dyslipidemia in the elderly. However, the only trial that included patients over 80 years was the Heart Protection Study （HPS）. Statins are considered the first line therapy for lowering low-density lipoprotein cholesterol （LDL-C）. Because lifestyle changes are very difficult to achieve, doctors in general tend to prescribe many drugs to control cardiovascular risk factors. However, healthy food consumption remains a cornerstone in primary and secondary cardiovascular prevention and should be implemented by everyone.

Risk factors for post-operative delirium in elderly Chinese patients

Objective:The purpose of this study was to systematically analyze the risk factors for post-operative delirium(PD)in elderly patients in an effort to provide a basis for developing relevant clinical interventions in China.Methods:All published studies focusing on the risk factors for PD among elderly patients in Wanfant Data,China National Knowledge Infrastructure(CNKI),and VIP were collected accord-ing to the inclusion and exclusion criteria of this study.A meta-analysis was performed on case-control studies using RevMan5.2 software,and the incidence of PD risk factors was calculated among case series.Results:Sixteen studies,including 8 case-control studies and 8 case series,were included in the current study.There were 353 cases and 2008 controls in the case-control studies.The pooled odds ratios(95%CI)of PD risk factors were as follows:hypoxemia,2.58(1.59~4.18);pulmonary infection,4.51(2.23~9.13);hypertension,2.16(1.20~3.89);coronary heart disease,1.50(0.82~2.73);post-operative pain,3.18(1.63~6.20);general anesthesia,3.64(0.94~14.11);operative time,1.70(0.79~3.66);and senility,0.52(-0.25~1.29).The meta-analysis showed that hypoxemia,pulmonary infection,hypertension,coronary heart disease,post-operative pain,gen-eral anesthesia,operative time,and senility were significant risk factors for PD.There were 404 cases in the case series,and the incidence of hypoxemia,hypertension,general anesthesia,dia-betes mellitus,senility,coronary heart disease,pulmonary infection,and cerebrovascular disease was 62.62%,55.90%,33.7%,24.8%,16.58%,15.3%,13.9%,and 12.1%,respectively,which was much higher than other risk factors.Conclusion:Senility,hypertension,coronary heart disease,diabetes mellitus,pulmonary infection,hypoxemia,post-operative pain,and general anesthesia are significant risk factors for PD among elderly Chinese patients.

老年胃溃疡出血患者再发出血的危险因素分析

目的探讨分析老年胃溃疡出血患者再发出血的相关危险因素。方法选取2020年3月至2022年3月许昌市中心医院收治的140例老年胃溃疡出血患者作为研究对象,收集患者性别、年龄、发病部位、胃溃疡长径、出血活动度、是否为胃溃疡A1期、是否合并幽门螺杆菌(Hp)感染、有无吸烟史、有无饮酒史、合并其他慢性疾病种类(≤2种、>2种)、是否进行消化内镜治疗、是否长期使用非甾体抗炎药(NSAIDs)等资料,并根据患者止血成功后1个月内是否再发出血将患者分为发生组与未发生组。多因素Logistic回归分析老年胃溃疡出血患者再发出血的危险因素。结果140例老年胃溃疡出血患者均于止血成功后随访1个月,随访过程中21例(150%)患者再发出血,设为发生组;119例(850%)患者未再发出血,设为未发生组。单因素分析结果显示,发生组胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs的患者比例均明显高于未发生组(χ^(2)=4269、7381、7580、11836,P=0039、0007、0006、0001);多因素Logistic回归分析结果显示,胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs是老年胃溃疡出血患者再发出血的独立危险因素(95%CI为1039~9660、1909~58707、0059~0585、1880~18559,P=0043、0007、0004、0002)。结论胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs是老年胃溃疡出血患者再发出血的独立危险因素,临床应根据患者具体情况制定针对性干预措施,以降低再出血发生风险。

Addressing diagnostic delays in inflammatory bowel diseases in Germany

Inflammatory bowel diseases(IBDs),including Crohn's disease(CD)and ulcerative colitis,are chronic inflammatory conditions of the gastrointestinal tract that necessitate timely diagnosis to prevent complications and improve patient outcomes.Despite advancements in medical knowledge and diagnostic techniques,significant diagnostic delays persist,particularly in CD.The study by Blüthner et al,published in the World Journal of Gastroenterology,elucidates the diagnostic delays experienced by German patients with IBD and identifies key risk factors contributing to these delays.

儿童消化性溃疡临床特征及危险因素分析

目的分析儿童消化性溃疡的临床特征及相关危险因素。方法选取2020年3月至2023年3月南阳医学高等专科学校第一附属医院收治的260例消化性溃疡患儿(设为溃疡组),以及260名健康儿童(设为健康组)作为研究对象,收集研究对象性别、年龄、家族史、饮食喜好以及患儿临床症状(呕吐、恶心、反酸、嗳气等)及体征(上腹压痛等)等情况,分析儿童消化性溃疡的临床特征,并采用多因素Logistic回归分析儿童消化性溃疡的相关危险因素。结果儿童消化性溃疡患儿中男性(8423%)多于女性(1577%),年龄以学龄期儿童(4692%)和青春期儿童(4077%)为主,溃疡类型以十二指肠溃疡(7115%)和单发溃疡(7269%)为主,主要临床表现为腹痛(7115%)、呕吐(6308%)和黑便(4885%),且腹痛部位主要为剑突下、脐周和上腹部,其中仅2212%表现为与进食相关。多因素Logistic回归分析结果显示,有家族史、喜好冷食、喜好酸辣、经常吃外卖、幽门螺杆菌感染、心理障碍、家庭不和睦、住校/小餐桌是儿童消化性溃疡的独立危险因素(95%CI为1848~32710、1040~3659、1334~11937、1182~11257、1499~9424、1935~20817、1188~6046、1178~4867,P=0005、0037、0013、0024、0004、0002、0017、0015)。结论儿童消化性溃疡以学龄期和青春期男性儿童为主,溃疡类型主要为十二指肠溃疡,临床表现主要为腹痛、呕吐和黑便;有家族史、喜好冷食、喜好酸辣、经常吃外卖、幽门螺杆菌感染、心理障碍、家庭不和睦、住校/小餐桌是儿童消化性溃疡的独立危险因素。

老年胃溃疡出血的危险因素分析

目的探讨导致老年胃溃疡患者出血的危险因素。方法选取2018年1月至2023年12月新建区中医院收治的80例老年胃溃疡患者为研究对象,根据是否有出血分为出血组和未出血组,收集两组患者的性别、年龄、有无吸烟史、有无饮酒史、有无Hp感染、有无胃溃疡病史、有无非甾体抗炎药(NSAIDS)应用史、溃疡的直径(<2cm或≥2cm)、有无合并十二指肠溃疡等临床资料进行分析,多因素Logistic回归分析筛选出老年胃溃疡出血的危险因素。结果通过单因素分析发现,有吸烟史(χ^(2)=5.12,P=0.02),有饮酒史(χ^(2)=6.05,P=0.01),Hp感染(χ^(2)=15.63,P<0.001),有胃溃疡病史(χ^(2)=4.18,P=0.04),有NSAIDS应用史(χ^(2)=4.53,P=0.03),溃疡的直径≥2cm(χ^(2)=6.37,P=0.01),合并十二指肠溃疡(χ^(2)=4.01,P=0.04)是老年胃溃疡出血的危险因素,将上述指标纳入多因素Logistic回归分析后发现,有吸烟史(OR=1.428,P=0.019)、有饮酒史(OR=2.016,P=0.031)、Hp感染(OR=7.524,P=0.003)、有NSAIDS应用史(OR=3.513,P=0.008)、溃疡的直径≥2cm(OR=1.984,P=0.039)是老年胃溃疡出血的独立危险因素。结论吸烟、饮酒、Hp感染、NSAIDS应用、溃疡的直径≥2cm是老年胃溃疡出血的危险因素,临床上针对合并上述高危因素的胃溃疡患者,应尽早识别,积极采取措施,以防止或减少老年胃溃疡患者出血。

老年患者院内难免压疮与院外带入压疮的危险营养因素分析

目的探讨老年院内难免压疮与院外带入压疮的危险营养因素的差异,提出有效防治措施。方法采集某院消化科年龄≥60岁的144例院内难免压疮(院内组)与77例院外带入压疮(院外组)老年患者的相关临床营养指标。用χ2检验,Logistic回归方法分析比较影响两组患者压疮发生的危险营养因素及差异。结果院外组老年压疮患者合并肿瘤、卧床时间≥20天、理想体重百分数<90%、小腿围<30 cm及未给予针对性营养支持者显著多于院内组(P<0.05);院内组老年压疮患者因疾病导致食欲减退、饮食类型改变及贫血者显著多于院外组(P<0.05)。Logistic回归分析结果:卧床时间长、小腿围围值减少、未给予针对性营养支持和饮食类型改变分别是导致院外组和院内组压疮发生的重要营养危险因素。结论 "人群针对性"的营养评估,应作为营养干预的基础列入压疮管理;建立出院老年卧床患者护理回访服务模式,有助于降低老年压疮发生率。

老年患者压疮风险现状调查与影响因素分析

目的:了解老年住院患者压疮风险现状及其相关影响因素。方法 :采用便利抽样方法,采用Braden量表、微型营养评价精法(MNA-SF)、尿失禁简表(ICIQ-SF)、面部表情疼痛量表(FPS-R)对267名老年患者进行问卷调查,通过秩和检验、Spearman相关分析和多元回归分析了解住院老年患者压疮风险现状与影响因素。结果:有压疮风险者58例(21.7%),轻度风险42例(15.7%),中度危险7例(2.6%),重度危险9例(3.4%);营养不良177例(66.3%);轻度尿失禁242例(90.6%),中度尿失禁19例(7.1%),重度尿失禁6例(2.3%);过去四周,有疼痛患者107例(40.1%)。单因素分析的结果显示压疮风险与性别、居住情况、文化程度、收入相关,多元回归分析的结果显示年龄、收入、营养不良、尿失禁、疼痛是压疮风险的独立影响因素。结论:高龄、低收入、营养不良、尿失禁、疼痛是压疮的危险因素,应给予积极的干预,可有效降低压疮的发生率,提高老年人的生活质量。

老年髋部骨折围手术期肺部感染的高危因素分析

目的 探讨老年髋部骨折患者围手术期肺部感染的高危因素.方法 对2002年1月-2011年12月进行手术治疗的老年髋部骨折患者715例进行回顾性分析,选择可能与老年髋部骨折围手术期肺部感染相关的因素作为自变量,围手术期肺部感染情况作为应变量.先用χ2检验进行单因素分析,然后将有统计学意义的单因素应用二分类Logistic回归模型行进一步分析.结果 715例患者中肺部感染组126例,无肺部感染组589例,患者的年龄、受伤至就诊时间、入院至手术时间、原呼吸系统疾病、基础疾病数、手术方式及麻醉方式是老年髋部骨折围手术期肺部感染的危险因素（P〈0.05）.而患者的年龄、原呼吸系统疾病、受伤至就诊时间及手术方式是髋部骨折患者围手术期出现肺部感染的高危因素（P〈0.05）.结论 高龄髋部骨折患者应尽早入院接受正规治疗,术前积极治疗合并症,改善肺功能,减少围手术期肺部感染的发生.

老年住院患者压疮危险因素的调查与分析

目的调查老年住院患者压疮的发生情况,并分析体重指数、血清白蛋白、血红蛋白等指标与压疮的相关性,以期更好地预防压疮。方法调查分析了214例老年住院患者相关资料,使用Braden评分量表进行评估老年患者,并测量各项指标,分析各项指标与压疮的相关性。结果214例老年患者中压疮评分平均为(16.97±3.24)分,其中极高危组27例(12.6%),高危组73例(34.1%),中危险组68例(31.8%),低危组35例(16.4%),无危组仅有11例(5.1%)。其中有15%的患者在活动能力、13%的患者在皮肤潮湿度、21%在营养状况方面存在障碍,血清白蛋白、血红蛋白及年龄与压疮的发生有关,而体重指数与之无关。结论老年患者为压疮高发人群,应针对其危险因素作好积极的预防和护理措施,以提高老年患者生存质量。

外科重症患者压疮发生高危因素分析

目的:探讨外科重症患者压疮发生相关危险因素,为制定预防压疮的有效措施提供依据。方法:采用自设外科重症患者压疮危险因素调查表收集某三级甲等医院47例外科重症患者资料,将其中发生院内压疮的14例患者设为压疮组,未发生压疮的33例患者设为对照组,两组间对20项指标进行单因素分析及多因素Logistic回归分析,找出压疮发生的危险因素。结果 :单因素分析显示,压疮组在ICU住院期间去甲肾上腺素使用总计小时数、动脉血乳酸最高值、机械通气总天数、血液净化治疗天数、排便失禁天数5项指标值高于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,去甲肾上腺素使用总计小时数、动脉血乳酸最高值是压疮发生的高危因素(P<0.05)。结论:应针对压疮高危人群和危险因素采取有针对性的措施,积极控制原发病,在抢救的同时采取积极的减压措施,以提高危重患者压疮防控的护理质量。

影响老年患者Braden评分分级的危险因素分析

目的探讨影响老年患者Braden评分分级的危险因素,以期为临床老年患者预防和治疗压疮提供依据。方法便利抽样法选择2013年7月至2014年6月在杭州市某三级甲等医院老干部病房新入院的262例老年患者为研究对象,所有患者均采用Braden评估量表进行评估,按照评估结果将其分为轻度危险(n=118)、中度危险(n=68)、高度危险(n=46)、极度危险四组(n=30)。统计各组患者的年龄、血压、是否存在偏瘫或截瘫、血清白蛋白水平、卧床时间、是否存在尿失禁或腹泻、皮肤水分和油分、皮肤pH值等,采用SPSS 20.0统计软件进行处理,分析影响老年患者Braden评分分级的危险因素。结果单因素分析表明,不同Braden分级的患者在年龄、血压、是否偏瘫或截瘫、血清白蛋白、卧床时间、是否存在尿失禁和腹泻、皮肤水分、皮肤pH值上的差异均有统计学意义(P<0.05或P<0.01)。对上述10项因素进行Logistic回归分析,结果表明年龄、皮肤pH值、血压、偏瘫、卧床时间等5项对Braden分级有影响(P<0.05)。结论年龄、皮肤pH值、血压、偏瘫、卧床时间是Braden评分分级的独立危险因素,应加强观察,从中获得压疮的预警信息,并采取适当的预防措施,以降低压疮的发生率。

老年患者发生褥疮的危险因素及预防

褥疮是临床老年患者尤其是长期卧床者的顽固并发症之一。作者综述了老年患者的皮肤特点及发生褥疮的危险因素,包括:运动能力减弱、感觉功能障碍、血液循环不良、营养不良以及皮肤环境等因素。通过正确地评估提出针对性的预防措施:缓解局部压力,减少磨擦力和剪力,避免潮湿,增加营养。