急诊高龄卫生保健相关性肺炎患者的临床特点分析

目的 :探讨急诊高龄卫生保健相关性肺炎(HCAP)患者的临床特征及预后。方法 :对2012年1月至2013年12月急诊病房收治的年龄>80岁的高龄肺部感染患者的临床资料进行回顾性分析,比较社区获得性肺炎(CAP)组与HCAP组患者的临床特征、病原学特点及预后。结果:165例高龄肺部感染患者中,HCAP组患者的平均住院天数[(19.9±12.3)d]显著长于CAP组[(14.6±7.4)d](P<0.05),且病死率显著高于后者(22.9%比7.3%,P<0.05)。2组患者症状不典型,有基础疾病者142例(86.1%)。2组患者均存在营养不良。HCAP组患者入院时的肺炎严重度指数(PSI)显著高于CAP组(125.2±27.1比116.8±25.8,P<0.05),PSI评分Ⅴ级的比例也显著高于后者(38.6%比23.2%,P

AnaIysis of clinical characteristics of elderly patients with health care associated pneumonia in emergency ward

Objective To analysis the clinical characteristics and outcome of elderly patients with health care associ- ated pneumonia （HCAP） in emergency ward. Methods The clinical materials of elderly patients with pneumonia in our e- mergency ward from Jan 2012 to Dec 2013 were analyzed retrospectively. Aged over 80 years patients with pneumonia were categorized into 2 groups： community acquired pneumonia （CAP） and HCAP. The clinical characteristics,pathogens and outcome were compared. Results Of the 165 patients, the average length of hospital stay in HCAP group was significantly longer than that in CAP group [（19.9±12.3） d vs （14.6±7.6） d, P〈0.05] and the mortality in HCAP group was significantly higher than that in CAP group（22.9% vs 7.3%, P〈0.05）. Patients of 2 groups had untypical clinical features, more underly- ing diseases（n=142, 86.1%） and malnutrition. The pneumonia severity index（PSI） and proportion of Class V in HCAP group were also significantly higher than that in CAP group （125.2±27.1 vs 116.8±25.8 and 38.6% vs 23.2%,P〈0.05）. Conclu- sions Elderly patients with pneumonia had more underlying diseases, malnutrition and untypical clinical features with high PSI on admission, longer hospital stay and high mortality, especially those with HCAP. Early diagnosis and treatment had important clinical impacts.