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目的探讨ICU内老年患者发生医院感染的危险因素,为医院感染的预防控制提供依据。方法选取医院2012年1月-2014年12月综合ICU内年龄≥65岁的老年住院患者共1 269例,按其是否在ICU内发生医院感染分为感染组195例和对照组1 074例;将两组患者的相关资料进行对比分析,分析其发生医院感染的独立危险因素;采用SPSS21.0软件进行统计分析。结果感染组平均住院时间为38d,长于对照组的19d,差异有统计学意义(P<0.01);病死率为43.08%,高于对照组的26.54%,差异有统计学意义(P<0.01);平均住院费用为162 720元,高于对照组的67 565元,差异有统计学意义(P<0.01);发生医院感染的独立危险因素包括胰腺炎(OR=5.20,95%CI2.83~9.56)、多次入住ICU(OR=4.22,95%CI 2.83~6.32)、院内获得多药耐药菌(OR=3.47,95%CI2.37~5.07)及APACHEⅡ评分(OR=1.04,95%CI1.01~1.06)。结论老年患者发生医院感染后住院时间延长,病死率增高,住院经济负担增加;胰腺炎、多次入住ICU、院内获得MDROs及APACHEⅡ评分为老年患者医院感染的独立危险因素。
Objective To explore the risk factors of nosocomial infection in elderly patients in ICU and to provide evidence for the prevention and control of nosocomial infections. Methods A total of 1 269 elderly hospitalized patients aged 65 or older in the ICU from January 2012 to December 2014 in our hospital were divided into 195 cases in the infection group and 1 074 cases in the control group according to whether hospital infection occurred in the ICU. The data of two groups of patients were compared and analyzed, and the independent risk factors of nosocomial infection were analyzed. The data were analyzed by SPSS21.0 software. Results The average length of stay in the infected group was 38 days, which was significantly longer than that of the control group (P <0.01). The mortality rate was 43.08%, higher than that of the control group (26.54%), with significant difference (P <0.01) ; The average cost of hospitalization was 162 720 yuan, which was higher than that of the control group (67 565 yuan), the difference was statistically significant (P <0.01); Independent risk factors for nosocomial infection included pancreatitis (OR = 5.20,95% CI 2.83 ~ (OR = 3.47, 95% CI 2.37 ~ 5.07) and APACHE II score (OR = 1.04, 95% CI, 9.56) CI1.01 ~ 1.06). Conclusions Senile patients have longer hospital stay after hospital infection, increased mortality and increased hospitalization cost. In pancreatitis, patients who have been admitted to ICU multiple times, MDROs and APACHE II scores obtained in hospital are independent risk factors for nosocomial infection in elderly patients.