非发酵菌所致老年人院内获得性肺炎危险因素的探讨

目的 探讨重症监护病房（ICU）老年患者院内获得性非发酵菌肺炎的危险因素。方法 采用非条件Logistic回归单因素及多因素分析方法回顾性分析2002年1月-2006年5月昆明医学院第一附属医院ICU老年人院内获得性非发酵菌肺炎（简称非发酵菌HAP）的相关危险因素。结果 多因素非条件Logistic回归分析发现，老年人非发酵菌HAP的发生与误吸（OR=41.682，95%CI2.907-597.730）、患有基础疾病（OR=12.130，95%CI1.518-96.964）、使用胃酸分泌抑制剂（OR=11.727，95%CI1.451-94.772）、使用镇静剂（OR=7.221，95%CI1.029-50.688）及气管插管/切开（OR=1.229，95%CI1.047-1.444）有关。结论 病人误吸、患有基础疾病、使用胃酸分泌抑制剂和镇静剂、气管插管/切开容易导致老年患者非发酵菌HAP的发生。

Analysis of risk factors for hospital acquired pneumonia caused by non-fermentative bacteria in elderly patients

Objective To explore the risk factors for hospital acquired pneumonia(HAP) caused by nonfermentative bacteria in elderly patients in intensive care unit(ICU).Methods The related risk factors for HAP caused by non-fermentative bacteria in elderly patients from Jan 2002 to May 2006 in ICU were reviewed and analyzed by binary logistic regression analysis.Results Logistic regression analysis revealed that the high risk factors for HAP caused by non-fermentative bacteria were aspiration(OR=41.682,95%CI 2.907-597.730),multiple underlying diseases(OR=12.130,95%CI 1.518-96.964),administration of antacids(OR=11.727,95%CI 1.451-94.772),administration of sedatives(OR=7.221,95%CI 1.029-50.688),tracheo-intubation or tracheostomy(OR=1.229,95%CI 1.047-1.444).Conclusion Aspiration,multiple underlying diseases,administration of antacids and sedatives,tracheo-intubation or tracheostomy were risk factors for HAP caused by non-fermentative bacteria in elderly patients.