老年重症病人发生血流感染的危险因素分析

doi:10.3969/j.issn.1003-9198.2022.10.017

摘要/Abstract

摘要： 目的探讨ICU老年重症病人发生血流感染(bloodstream infections, BSI)的危险因素。方法回顾性分析南京市中医院2017年1月至2020年12月重症监护病房内诊断为BSI的老年病人(BSI阳性组)64例以及同时期未发生BSI的老年病人(BSI阴性组)56例,比较2组病人性别、年龄、APACHEⅡ评分、Nutric评分、合并症、住院时间、侵入性操作等资料,采用多因素Logistic回归分析筛选BSI发生的危险因素。结果单因素分析显示,BSI阳性组病人营养风险更高,且肿瘤、糖尿病、泌尿系统感染、胃肠功能紊乱发病率以及抗菌药物暴露史均高于BSI阴性组,差异均有统计学意义(P＜0.05)。多因素 Logistic 回归分析显示,合并恶性肿瘤(OR=2.476,95%CI:1.032~5.941)、胃肠功能紊乱(OR=3.410,95%CI:1.366~8.514)、有抗菌药物暴露史(OR=3.705,95%CI:1.516~9.057)、高营养风险(OR=7.005,95%CI:2.588~18.957)是老年重症病人发生BSI的独立危险因素。结论合并恶性肿瘤、胃肠功能紊乱、有抗菌药物暴露史以及高营养风险的老年重症病人发生BSI的风险较高。

关键词: 血流感染, 胃肠功能紊乱, 危险因素, 老年人

Abstract: Objective To investigate the risk factors of bloodstream infections(BSI) in the aged critically ill patients in Intensive Care Unit(ICU). Methods The study retrospectively analyzed the clinical data of 120 cases of aged critically ill patients admitted to Nanjing Hospital of Chinese Medicine from January 2017 to December 2020. According to the results of blood culture, the cases were divided into BSI group(n=64) and non-BSI group(n=56). The differences in gender, age, APACHEⅡscore, Nutric score, comorbidities, the length of ICU stay, invasive operations between the two groups were analyzed. Then multivariate Logistic regression analysis was performed to investigate the risk factors of BSI. Results Univariate analysis showed that the patients in BSI group had higher nutritional risk than non-BSI group. The incidence rates of tumor, diabetes, urinary tract infection, gastrointestinal dysfunction and antimicrobial exposure in BSI group were higher than those in non-BSI group(P < 0.05). Multivariate Logistic regression analysis showed that malignant tumors (OR=2.476, 95%CI: 1.032-5.941), gastrointestinal dysfunction (OR=3.410, 95% CI: 1.366-8.514), history of antimicrobial exposure (OR=3.705, 95% CI: 1.516-9.057) and high nutritional risk (OR=7.005, 95% CI: 2.588-18.957, P< 0.01) were the independent risk factors of BSI in the aged critically ill patients. Conclusions The aged critically ill patients with high malnutrition risk, malignant tumor, gastrointestinal dysfunction and history of antimicrobial exposure are prone to suffer from BSI.

Key words: bloodstream infections, gastrointestinal dysfunction, risk factors, aged

中图分类号:

R559

陈畅泉, 许飚. 老年重症病人发生血流感染的危险因素分析[J]. 实用老年医学, 2022, 36(10): 1046-1049.

CHEN Chang-quan, XU Biao. Risk factors of bloodstream infections in the aged critically ill patients[J]. Practical Geriatrics, 2022, 36(10): 1046-1049.

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