摘要
目的:对2型糖尿病合并肺炎患者的预后相关危险因素进行分析。方法:选择2022年1月至2023年12月在上海市第四人民医院住院治疗的2型糖尿病合并肺炎患者共1738例为研究对象进行回顾性研究,将患者按照预后情况分为存活组和死亡组,用Logistic回归方法分析患者的性别、年龄、检出多重耐药菌(MDRO)、合并脓毒症、使用抗生素、是否手术、是否置管、高血糖水平等因素与预后的关系。结果:死亡组患者共211例(12.1%),平均年龄(80.43±11.10)岁,男性占62.6%。存活组1527例(87.9%),平均年龄(76.69±11.80)岁,男性占56.2%。死亡组住院期间检出MDRO(31.3%)、使用抗菌药物(57.3%)、经历手术(66.4%)、接受三导管置管操作(56.4%)、出院诊断中有脓毒症(19.4%)的患者构成比均高于存活组(分别为14.3%、47.2%、47.0%、27.4%和3.3%,P<0.01或P<0.001)。二元Logistic回归分析结果显示,高龄(OR=1.07,95%CI:1.05-1.09,P<0.001)、三导管置管操作(OR=2.13,95%CI:1.39-3.24,P=0.001)、合并脓毒症(OR=9.85,95%CI:3.77-26.84,P<0.001)、血糖水平高(OR=1.35,95%CI:1.27-1.45,P<0.001)是2型糖尿病合并肺炎患者死亡的独立危险因素。与无置管的患者相比,有创气管插管的患者、导尿管留置合并气管插管的患者、导尿管留置的患者死亡的可能性更大。结论:在2型糖尿病合并肺炎的患者中,高龄、合并脓毒症、有三导管置管操作、血糖水平高为死亡的独立危险因素;与无置管的患者相比,有气管插管的患者、有导尿管合并气管插管的患者、有导尿管的患者死亡的可能性更大。
Objective:To analyze the prognosis risk factors of type II diabetes mellitus complicated with pneumonia.Methods:A total of 1738 patients with type II diabetes complicated with pneumonia hospitalized in Shanghai Fourth People's Hospital from January 2022 to December 2023 were selected for retrospective study.They were divided into survival group and death group according to prognosis.Logistic regression analysis was used to analyze the relationship between the patients'prognosis and factors such as gender,age,detection of multi-drug resistant organism(MDRO),sepsis,antibiotic use,whether to operate,whether to place a tube,and high blood glucose level.Results:There were 211 patients(12.1%)in the death group,with an average age of(80.43±11.10)years old,and 62.6%were males.There were 1527 patients(87.9%)in the survival group,with an average age of(76.69±11.80)yeas old,and 56.2%were males.During hospitalization,the proportion of patients with MDRO(31.3%),antibiotics(57.3%),surgical records(66.4%),three catheterization procedures(56.4%),and discharge diagnosis of sepsis(19.4%)was higher in the death group than those in the survival group(14.3%,47.2%,47.0%,27.4%and 3.3%,respectively,P<0.01 or P<0.001).Binary logistic regression analysis showed that the elderly(OR=1.07,95%CI:1.04-1.09,P<0.001),three catheter catheterization(OR=2.13,95%CI:1.39-3.24,P=0.001),sepsis(OR=9.85,95%CI:3.77-26.84,P<0.001),high blood glucose level(OR=1.35,95%CI:1.27-1.45,P<0.001)were independent risk factors for the death of type II diabetes patients with pneumonia.Compared with patients without catheterization,patients with invasive tracheal intubation,catheterization combined with tracheal intubation,and catheterization were more likely to die.Conclusions:In type II diabetes patients with pneumonia,old age,sepsis,triple catheterization and high blood glucose level are independent risk factors for death.Compared to patients without catheterization,patients with airway catheterization,those with catheterization combined with airway catheterizatio
作者
王玮
韩乔丽
Wang Wei;Han Qiaoli(Office of Healthcare-associated Infection Management,Shanghai Fourth People's Hospital,Shanghai 200434,China)
出处
《感染、炎症、修复》
2023年第3期180-182,186,共4页
Infection Inflammation Repair
关键词
2型糖尿病
肺炎
预后
置管
影响因素
Type II diabetes
Pneumonia
Prognosis
Catheterization
Influence factor
