重型颅脑损伤早期发生肺部感染的危险因素

目的 分析重型颅脑损伤患者早期发生肺部感染的危险因素,为临床预防肺部感染提供理论依据。方法 回顾分析300例重型颅脑损伤患者的临床资料,按住院期间有无感染分为无感染组(147例)和感染组(153例),应用单因素及多因素Logistic回归分析比较这两组间各因素的差异。结果 300例重型颅脑损伤患者合并肺部感染者153例(51%),多因素Logistic回归分析发现吸烟、GCS评分、糖皮质激素为独立危险因素,其OR值(95%CI)分别为0.327(0.151～0.709)、0.292(0.212～0.403)、2.196(1.007～4.786)。受试者工作曲线示:用GCS评分预测重型颅脑损伤患者发生肺部感染的临界值为5,具有很强的预测价值。结论 重型颅脑损伤患者肺部感染发生率高,要针对高危患者加强预防措施。

Analysis of risk factors of pulmonary infection in the early stage of severe head injury

Objective To analyze the risk factors of early pulmonary infection in patients with severe craniocerebral injury.Methods The clinical data of 300 patients with severe head injury were retrospectively analyzed,and the patients were divided into the non-infection group (147 cases) and the infection group (153 cases) according to the occurrence of pulmonary infection.Univariate analysis and multivariate Logistic regression analysis were used to compare the differences between the two groups.Results The incidence of pulmonary infection in 300 patients with severe head injury was 51% (153/300).Multiple factor logistic regression analysis showed that smoking,GCS score and glucocorticoid were independent risk factors of pulmonary infection in patients with severe head injury,and the OR (95%CI) were 0.327 (0.151-0.709),0.292 (0.212-0.403) and 2.196 (1.007-4.786),respectively.Having found that Glasgow Coma Scale (GCS) is a strong predictor outcome(considering favourable outcome),ROC curve was made for finding out the optimal cutoff ( GCS=5) as a predictor.Conclusion The incidence of pulmonary infection in patients with severe head injury is high and prevention measures should be strengthened for high-risk patients to reduce the incidence of infection.