高血压脑出血老年患者院内获得性肺炎的危险因素

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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.

Key words： Elderly Cerebral hemorrhage Hypertension Hospital acquired pneumonia Risk factor

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	Articles by authors
	HE Sen
	WEI Ming-li
	XIE Fei
	XUE Fang
	HAO Jian-qiang
	ZHANG Yuan-jun

Cite this article:

HE Sen,WEI Ming-li,XIE Fei, et al. Risk factors for hospital acquired pneumonia in elderly patients with hypertensive intracerebral hemorrhage[J]. 中国当代医药, 2021, 28(10): 12-15转19.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I10/12

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