摘要
目的探讨老年重症肺炎的危险因素及预后。方法收集2007年6月~2008年12月入住内科ICU的老年（≥65岁）肺炎患者101例,其中62例符合老年重症肺炎诊断标准,将其设为病例组,余下39例老年非重症肺炎为对照组,采用单因素分析（t检验和秩和检验）及多因素进行分析。结果病原菌主要以G-为主,占62.69%,排在首位的是鲍曼不动杆菌（25.37%）。Logistic多元回归结果显示FineⅣ级以上、呼吸衰竭、PT〉13.0S、TBIL〉17.0μmol/L是发生老年重症肺炎的危险因素,而血红蛋白〈90 g/L,机械通气,Fine V级是影响老年重症肺炎的独立预后因素。结论 Fine分级Ⅳ级以上、呼吸衰竭、PT〉13.0S、TBIL〉17.0μmol/L可能是老年重症肺炎重要的危险因素;血红蛋白〈90 g/L,机械通气,Fine V级是老年重症肺炎的独立预后因素,其中Fine危险分级对于老年肺炎患者的病情评估及预测预后有较大价值。
Objective To study elderly patients with severe pneumonia risk factors and prognostic factors.MethodsBy a case-control study,collection 101 case from Fujian Provincial Hospital ICU in June 2007 ~ December 2008 of elderly（≥65 years） pneumonia patients,62 cases are elder severe pneumonia,set it to case group,and the remained 39 cases of elder non-severe pneumonia as the control group.Univariate analysis（chi-square test and rank sum test） and multivariate Logistic regression were used for statistics analysis.ResultsThe average age of patients is [mean age（79.32±6.71） years],the total number of hospitalization days is [mean（53.53±60.12） days],the number of hospitalization days in ICU is[mean（33.08±48.77） days],fatality rate is 32.25%.The main pathogen is gram negative bacilli（62.69%）,acinetobacter baumannii occupied 25.37%.Multivariable logistic regression analysis showed that： Fine ⅣⅤ,respiratory failure,PT13.0S and TBIL17.0 μmol/L are the independent risk factors of occurred elderly severe pneumonia.Haemoglobin 90 g/L,mechanical ventilation and FineⅤ are independent predictive factor.ConclusionFine ⅣⅤ,respiratory failure,PT13.0S and TBIL17.0 μmol/L are the independent risk factors of occurred the elder severe pneumonia.Haemoglobin90 g/L,mechanical ventilation and FineⅤare independent predictive factor.Fine′s risk classification has great value in elderly patient′s condition assessment and prediction of prognosis.
出处
《临床肺科杂志》
2011年第4期499-501,共3页
Journal of Clinical Pulmonary Medicine
基金
福建省科技厅重点项目(2009Y0010)
福建省医学创新课题(2009-CXB-2)
关键词
老年重症肺炎
危险因素
预后因素
Fine危险分级
severe pneumonia in elderly
risk factors
predictive factor
Fine′s risk classification
