老年急性冠脉综合征患者医院感染的临床特点及危险因素分析

目的探讨急性冠脉综合征老年患者的临床特点和并发医院感染的危险因素。方法选择四川省人民医院2018年6月1日至2019年5月31日收治的发生急性冠脉综合征的老年住院患者792例,按照住院期间发生医院感染的情况,统计患者的临床数据、基础疾病并计算Charlson共病指数,比较感染组与非感染组之间的临床特点和危险因素。结果792例老年急性冠脉综合征患者中发生医院感染者126例,感染率15.90%;感染部位主要为呼吸道和泌尿道感染;侵入性操作、糖尿病、低蛋白血症、心功能Killip 3~4级、左心室射血分数<0.4、急性心肌梗死是老年急性冠脉综合征患者发生医院感染的独立危险因素(P<0.05)。结论老年急性冠脉综合征患者是医院感染的易感人群,其危险因素较多,有针对性地对老年患者进行干预,有助于降低老年急性冠脉综合征患者死亡率。

Clinical characteristics and risk factors of nosocomial infection in elderly patients with acute coronary syndrome

Objective To investigate the clinical features and risk factors of nosocomial infection in the elderly with acute coronary syndrome.Methods Elderly patients with acute coronary syndrome treated in Sichuan Provincial People’s Hospital between June 1,2018 and May 31,2019 were selected as the research objects.The clinical data,basic diseases,the Charlson comorbidity index between nosocomial infection group and non-infection group were collected,the clinical features and influencing factors were analyzed.Results In the 792 cases of elderly patients with acute coronary syndrome,there were 126 cases of nosocomial infection,with the infection rate 15.90%;The patients who had respiratory system infection were dominant,followed by the patients with urinary tract infection;The result of the multivariate analysis showed that the independent influencing factors were invasive procedures,diabetes,hypoproteinemia,cardiac function(Killip gradeⅢ~Ⅳ),left ventricular ejection fractions value<0.4 and acute myocardial infarction(P<0.05).Conclusion The patients with acute coronary syndrome in the elderly were susceptible group of hospital infection due to multiple risk factors.Taking reasonable intervention measures of according to the influencing factors was helpful to cut down the incidence of nosocomial infection in the elderly patients with acute coronary syndrome,which was of great significance to improve the clinical prognosis.