1.Department of Neurosurgery, the First People′s Hospital of Ziyang City, Sichuan Province, Ziyang 641300, China;
2.Department of Respiratory, the First People′s Hospital of Ziyang City, Sichuan Province, Ziyang 641300, China;
3.Intensive Care Unit, the First People′s Hospital of Ziyang City, Sichuan Province, Ziyang 641300, China
Abstract：Objective To investigate the risk factors of hospital acquired pneumonia (HAP) in elderly patients with hypertensive intracerebral hemorrhage (HICH).Methods Clinical data of 137 elderly patients with HICH admitted to the First People′s Hospital of Ziyang City from January 2017 to December 2019 were retrospectively analyzed, including basic information, infection status and microbiological test results.Risk factors for HAP and characteristics of common pathogens were analyzed.Results Among 137 elderly patients with HICH, 85 cases were complicated with HAP, the incidence was 62.04%.A total of 116 strains of pathogens were isolated, including 88 strains (75.86%) of Gram-negative bacteria，24 strains (20.69%) Gram-positive bacteria and 4 strains (3.45%) of fungi were detected.Single factor analysis showed that there were significant differences in age ≥80 years old, history of chronic pulmonary disease, diabetes mellitus，vomited, glasgow coma scale (GCS) score ≤8 points at admission, nasal feeding, trachea interventional therapy, hypoproteinemia, use of corticosteroids and proton pump inhibitors (PPI), for HAP or not in elderly patients with HICH (P＜0.05).Multivariate analysis showed that age ≥80 years old (β=2.39, OR=9.71, 95%CI 9.12-10.35), history of chronic pulmonary disease (β=2.46, OR=10.65, 95%CI 9.45-11.11), diabetes mellitus (β=1.93, OR=2.57, 95%CI 1.55-5.93), vomited after onset (β=1.67, OR=5.13, 95%CI 2.11-10.52), at admission GCS score ≤8 points (β=2.25, OR=8.89, 95%CI 8.27-9.39), nasal feeding (β=1.21, OR=3.19, 95%CI 1.51-7.01), trachea interventional therapy(β=2.73, OR=14.61, 95%CI 14.16-15.62), hypoproteinemia (β=1.13, OR=2.91, 95%CI 1.20-6.03), use of Corticosteroids (β=0.47, OR=1.52, 95%CI 1.15-4.12) and PPI (β=0.52, OR=1.63, 95%CI 1.29-2.54) were independent risk factors for HAP in elderly patients with HICH (P＜0.05).Conclusion There are many risk factors and high incidence of HAP in elderly patients with HICH.Therefore, individualized prevention and treatment programs should be formulated according to the risk factors to reduce the incidence of HAP.
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