急性脑出血患者院内感染相关因素分析

目的:探讨急性脑出血患者院内感染的发生率及导致急性脑出血患者发生院内感染的相关因素,为防治急性脑出血患者院内感染提供理论依据。方法:对我院神经内科自2011年1～12月收治的246例急性脑出血患者进行回顾性分析,调查急性脑出血患者院内感染的发生率及导致其发生院内感染的相关因素,进一步分析院内感染与急性脑出血患者预后的关系。结果:246例急性脑出血发生院内感染57例,发生率为23.2%。单因素分析发现,患者的年龄、GCS评分、吸烟史、糖尿病史、慢性支气管炎、低蛋白血症、院内侵袭性操作及呼吸机使用是脑出血患者院内感染发生的危险因素,差异有统计学意义。多因素分析发现,吸烟史、糖尿病史、慢性支气管炎、低蛋白血症及入院时GCS评分是影响脑出血患者发生院内感染的独立危险因素;院内感染和GCS评分是影响脑出血患者预后的独立危险因素。结论:脑出血患者院内感染发生率高,且是影响脑出血患者预后的独立危险因素。

Correlative analysis of the influencing factors for hospital-acquired infections in patients with acute intracerebral hemorrhage

Objective:To investigate the incidence and the influencing factors of hospital-acquired infections(HAI) in patients with acute intracerebral hemorrhage(ICH) for scientific evidence to prevent nosocomial infection in this entity.Methods:The clinical data of 246 consecutive patients with ICH,admitted to our department between January and December of 2011,were retrospectively analyzed.Logistic regression analysis was performed to confirm the relevant factors of HAI and the influencing factors with prognosis of acute ICH.Results:HAIs occurred in 57 of the 246 acute ICH patients.The incidence of HAI was 23.2%.Univariate analysis revealed that the high risk factors for HAIs were associated with ages(t=4.392,P<0.001),Glasgow coma scale(t=10.524,P<0.001),history of smoking(χ2=13.88,P<0.001),diabetes(χ2=5.26,P=0.022),chronic bronchitis(χ2=8.346,P=0.004),hypoproteinemia(χ2=25.19,P<0.001),bleeding site(χ2=21.21,P=0.001),invasive operation and mechanical ventilation(χ2=29.14,P<0.001),whereas the logistic regression analysis showed that the independent risk factors for ICH from HAIs were involved in history of smoking(OR= 5.35,95% CI 2.25-12.74,P<0.001),diabetes(OR=3.05,95% CI 1.02-9.11,P=0.046) and chronic bronchitis(OR= 7.71,95% CI 1.38-43.17,P=0.02),hypoproteinemia(OR=7.35,95% CI 2.29-23.52,P=0.001) and Glasgow coma scale(OR=0.65,95% CI 0.57-0.73,P<0.001).Moreover,HAIs(OR=3.21,95% CI 1.05-9.83,P=0.041)were independent risk factors for poor outcome of patients with acute ICH.Conclusion:Patients with acute ICH has a higher incidence of HAIs,which is also an independent risk factor affecting the prognosis of such entity.