老年人急性白血病患者医院感染危险因素的Logistic回归模型分析

目的 探讨老年人急性白血病(AL)医院感染的特点,分析引起医院感染的危险因素,为医院感染防治措施的制定提供客观依据.方法 对1999年1月至2008年1月9年间住院的116例老年AL患者医院感染发生率、感染部位、致病菌和易感因素等进行回顾性分析,并与同期非老年人组进行比较.结果 老年人组116例中发生医院感染73例(62.9%),感染死亡38例(52.1%),明显高于同期非老年人组,差异有统计学意义(P＜0.01).感染部位以口腔和呼吸道感染为主;多部位感染、重症感染高于非老年人组.致病菌以革兰阴性杆菌为主.多因素分析显示外周血中性粒细胞(ANC)绝对值、化疗周期、近期感染、治疗阶段、住院时间及住院季节是老年人AL医院感染的独立危险因素.结论 老年人AL医院感染发生率高,感染死亡率高,外周血ANC绝对值、化疗周期、近期感染、治疗阶段、住院天数及住院季节是独立危险因素.

Hospital infection and its risk factors in elderly acute leukemia patients with multifactor logistic-regression analysis

Objective To investigate the characteristics and risk factors of hospital infection in elderly patients with acute leukemia and provide basis for its prevention and treatment. Methods The hospital infection rate,infection sites,pathogenic bacteria and infectious factors of 116 elderly patients with acute leukemia between January 1999 and January 2008 were analyzed retrospectively,and compared with groups of non-elderly patients in the corresponding period. Results The incidence of hospital infection 62.9 %(73/116)]and death52.1 %(38/116)]in elderly patients were higher than that of non-elderly ones (P <0.01). The most commonly infective sites were oral cavity and respiratory system. The multiple and serious infection in elderly patients was more than that of non-elderly noes. The common pathogenic bacteria were mainly grant-negative one. The results of multivariate aralysis showed that the absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization were found as independent risk factors for hospital infection in elderly patients with acute leukemia. Conclusion The incidence of hospital infection and death in elderly patients was high. The absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization are independent risk factors for elderly patients with acute leukemia.