北京某社区老年与非老年居民感染发生率及预后比较  

Incidence and Prognosis of Infections in the Elderly and Non-elderly Residents in a Community of Beijing

作　　者：周建芳[1] 杜斌 ZHOU Jianfang;DU Bin(Department of Critical Care Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100105,China;Medical ICU,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京天坛医院重症医学科,北京100105 [2]中国医学科学院北京协和医学院北京协和医院内科ICU,北京100730

出　　处：《中国医学科学院学报》2019年第6期772-777,共6页Acta Academiae Medicinae Sinicae

基　　金：北京市科委“首都临床特色应用研究”专项课题(Z1311017002213112);中国医学科学院医学科学创新基金(2016-12M-1-014)~~

摘　　要：目的比较北京市社区老年与非老年居民感染发生率及预后。方法对所有居住于北京月坛街道、并在研究期限内(2012年7月1日至2014年6月30日)入住医院的成年患者进行筛选,合并感染者将被纳入分析。结果共筛查19472例住院患者,其中3449例合并感染,感染发生率为17.7%。老年患者感染发生率明显高于非老年患者(21.5%比10.5%,χ^2=362.202,P<0.001)。感染部位以下呼吸道最常见,其次为泌尿生殖系统。老年感染患者住院病死率明显高于非老年患者(13.6%比3.4%,χ^2=56.829,P<0.001),且病死率随年龄增加而增长。Logistic回归分析结果显示,高龄、急诊手术入院、合并实体肿瘤、慢性心功能不全、Charlson评分高、腹腔、胃肠道、下呼吸道、血行性感染以及医院获得性感染为老年感染患者死亡的独立危险因素。结论月坛街道居民老年患者感染发生率明显高于非老年患者,且住院时间更长,住院病死率更高。Objective To compare the incidence and prognosis of infections between elderly and non-elderly residents in a community of Beijing.Method Adult inpatients during the study period(from July 1,2012 to June 30,2014)living in Yuetan Subdistrict of Beijing were screened for infections,and patients with infections were included into the analysis.Results A total of 19472 patients were screened,and infections were found in 3449 patients(17.7%).The incidence was significantly higher in the elderly than that in the non-elderly patients(21.5%vs.10.5%,χ^2=362.202,P<0.001).Lower respiratory tract was the most commonly affected site,followed by genitourinary system.The mortality rate of the elderly patients with infections was significantly higher than that of the non-elderly patients with infections(13.6%vs.3.4%,χ^2=56.829,P<0.001)and increased with age.Logistic regression analysis found that older age,emergency surgery,comorbid cancer,chronic cardiac insufficiency,higher Charlson comorbidity index,intra-abdominal infection,gastrointestinal infection,bloodstream infection,lower respiratory infection,and hospital-acquired infection were independent risk factors of death for the elderly patients.Conclusion The incidence of infections in the elderly patients living in Yuetan Subdistrict of Beijing is much higher than that of the non-elderly patients,and elderly infected patients had longer hospital length of stays and higher mortality rates than non-elderly infected patients.

关 键 词：社区居民 感染 病死率 危险因素 

分 类 号：R592[医药卫生—老年医学]