教学医院ICU老年患者医院感染危险因素及预后  

Risk factors for healthcare-associated infections in elderly patients in ICUs of a teaching hospital and prognosis

作　　者：黄文治[1] 朱仕超[1] 乔甫[1] 王妍潼[1] 庄红娣[1] 尹维佳[1] 宗志勇[1] 

机构地区：[1]四川大学华西医院医院感染管理科,四川成都610041

出　　处：《中华医院感染学杂志》2016年第18期4192-4194,共3页Chinese Journal of Nosocomiology

基　　金：医院感染预防与控制能力建设项目(CHA-2012-XSPX-0629-1)

摘　　要：目的探讨ICU内老年患者发生医院感染的危险因素,为医院感染的预防控制提供依据。方法选取医院2012年1月-2014年12月综合ICU内年龄≥65岁的老年住院患者共1 269例,按其是否在ICU内发生医院感染分为感染组195例和对照组1 074例;将两组患者的相关资料进行对比分析,分析其发生医院感染的独立危险因素;采用SPSS21.0软件进行统计分析。结果感染组平均住院时间为38d,长于对照组的19d,差异有统计学意义（P〈0.01）;病死率为43.08%,高于对照组的26.54%,差异有统计学意义（P〈0.01）;平均住院费用为162 720元,高于对照组的67 565元,差异有统计学意义（P〈0.01）;发生医院感染的独立危险因素包括胰腺炎（OR=5.20,95%CI2.83~9.56）、多次入住ICU（OR=4.22,95%CI 2.83~6.32）、院内获得多药耐药菌（OR=3.47,95%CI2.37~5.07）及APACHEⅡ评分（OR=1.04,95%CI1.01~1.06）。结论老年患者发生医院感染后住院时间延长,病死率增高,住院经济负担增加;胰腺炎、多次入住ICU、院内获得MDROs及APACHEⅡ评分为老年患者医院感染的独立危险因素。OBJECTIVE To explore the risk factors for healthcare-associated infections（HAIs）in elderly patients in ICUs so as to provide guidance for control of the HAIs.METHODS A total of 1 269 elderly patients with no less than 65 years of age who were treated in the comprehensive ICUs from Jan 2012 to Dec 2014 were enrolled in the study and divided into the infection group with 195 cases and the control group with 1 074 cases according to the status of HAIs during the ICU stay.The related data were observed and compared between the two groups of patients,the independent risk factors for the HAIs were analyzed,and the statistical analysis was performed with the use of SPSS21.0software.RESULTS The average length of hospital stay of the infection group was 38 days,longer than 19 days of the control group（P〈0.01）.The mortality rate of the infection group was 43.08%,higher than 26.54% of the control group（P〈0.01）.The average hospitalization cost of the infection group was 162 720 yuan,more than 67 565 yuan of the control group（P〈0.01）.The independent risk factors for the HAIs included the pancreatitis（OR=5.20,95%CI2.83~9.56）,ICU stay for many times（OR=4.22,95%CI 2.83~6.32）,hospital-acquired multidrug-resistant organisms（MDROs）（OR=3.47,95%CI 2.37~5.07）,and APACHEⅡscore（OR=1.04,95%CI1.01~1.06）.CONCLUSIONThe HAIs in the elderly patients may extend the length of hospital stay and increase the mortality rate as well as the economic burden.The independent risk factors for the HAIs in the elderly patients include the pancreatitis,ICU stay for many times,hospital-acquired MDROs,and APACHEⅡ score.

关 键 词：老年患者 医院感染 危险因素 预后 

分 类 号：R181.3[医药卫生—流行病学]