神经内科住院病例医院感染影响因素及对医疗费用的影响  

Influencing factors for nosocomial infection in hospitalized patients of neurology department and impact on medical cost

作　　者：张洪鹏 杜继臣[1] 李锦姬[1] ZHANG Hong-peng;DU Ji-chen;LI Jin-ji(Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院信息处,北京100049

出　　处：《中华医院感染学杂志》2021年第14期2228-2231,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨神经内科住院病例医院感染分布、影响因素及对医疗费用的影响。方法通过医院信息系统(HIS)提取医院2019年1月-12月神经内科经正常治疗出院3157例,符合纳入、排除标准的全部患者资料,包括患者一般信息、入院情况、等级护理天数、入住重症监护病房/冠心病监护病房(ICU/CCU)天数、住院期间抢救和危重情况、出院感染诊断等。通过回顾性分析,探讨医院感染的影响因素。结果符合纳入、排除标准病例1902人次,发生医院感染45例次,感染发生率2.37%。神经内科医院感染病种以上呼吸道感染最多,17例,占37.78%;其次为甲型流感、细菌性肺炎、肺部感染,各有7例。入院时病情危重、住院时间长、在院期间报病危病重,感染发生率较高,差别有统计学意义(P<0.05)。多因素Logistic回归分析,住院时间长、入院时危重、在院报危重是感染的危险因素(P<0.05),而有特级或一级护理为感染的保护因素(P<0.05)。以中位数计算,感染患者延长了住院日3.97 d,增33.72%;增加医疗费0.98万元,增43.10%;增加药费0.63万元,增84.22%。结论发生医院感染延长了患者住院天数,增加了疾病负担。住院时间长、入院时危重、在院报病情危重是发生感染的高危因素,必要时根据患者自身情况提升护理等级,可减少感染风险。OBJECTIVE To explore the influencing factors for nosocomial infection in hospitalized patients of neurology department and observe the impact on medical cost.METHODS From Jan 2019 to Dec 2019,a total of 3157 patients who were discharged from neurology department after normal treatment were enrolled in the study by means of hospital information system(HIS).The data of all the patients that conformed to inclusion and exclusion criteria were collected,including general information,status at the admission,days of graded care,length of intensive care unit/coronary care unit(CCU)stay,rescue during hospital stay,critical illness condition and diagnosis of infection at discharge.The influencing factors for the nosocomial infection were observed.RESULTS Totally 1902 case-times of patients conformed to the inclusion and exclusion criteria,and 45 case-times of patients had nosocomial infection,with the infection rate 2.37%.Among the patients with nosocomial infection in the neurology department,17 had upper respiratory tract infection,accounting for 37.78%;7 had influenza A,7 had bacterial pneumonia,and 7 had pulmonary infection.The incidence of infection was relatively high among the patients with critical illness condition,long length of hospital stay and critically or terminally ill report during hospital stay,and there was significant difference(P<0.05).Multivariate logistic regression analysis showed that long length of hospital stay,critical illness condition at the admission and critically or terminally ill report were the risk factors for the infection(P<0.05),while the special or first-grade care was the protective factor(P<0.05).The median length of hospital stay extended by 3.97 days,with an increase of 33.72%;the medical cost was increased by 9800 yuan,with an increase of 43.10%;the cost of drugs was increased by 6300 yuan,with an increase of 84.22%.CONCLUSION The nosocomial infection extends the length of hospital stay and increase the disease burden.The long length of hospital stay,critical illness condition a

关 键 词：神经内科 医院感染 影响因素 医疗费用 

分 类 号：R741[医药卫生—神经病学与精神病学]