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目的了解慢性阻塞性肺疾病急性加重期(AECOPD)住院患者病死率及死亡相关因素。方法采用回顾性分析,收集北京大学第三医院2007年1月至2008年12月呼吸科收住的AECOPD患者138例。总结患者特点,并采用单因素及多因素Logistic回归进行分析。结果 AECOPD住院患者院内病死率为21.7%。单因素分析发现下列因素与AECOPD住院死亡相关:年龄、住院时间长短、PASP、入住ICU、合并肺炎、贫血、肾功能不全、Ⅱ型呼吸衰竭、心房颤动、休克、气胸。多因素Logistic回归分析提示肺炎(OR=42.488)、高PASP(≥45mmHg)(OR=15.914)、贫血(OR=7.693)、心房颤动(OR=6.215)以及入住ICU(OR=4.927)是AECOPD患者住院死亡的独立危险因素。结论 AECOPD住院患者病死率高,肺炎、高PASP(≥45mmHg)、贫血、心房颤动以及入住ICU是AECOPD患者住院死亡的独立危险因素。
Objective To understand the mortality and mortality-related factors of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A retrospective analysis was performed to collect 138 AECOPD patients admitted to the Department of Respiratory Medicine from Peking University Third Hospital from January 2007 to December 2008. The characteristics of the patients were summarized and analyzed by single factor and multivariate Logistic regression. Results The hospital mortality rate of AECOPD inpatients was 21.7%. Univariate analysis found that the following factors were associated with hospital mortality in AECOPD: age, hospital stay, PASP, ICU admission, pneumonia, anemia, renal insufficiency, type II respiratory failure, atrial fibrillation, shock, pneumothorax. Multivariate logistic regression analysis showed that patients with AECOPD had higher incidence of pneumonia (OR = 42.488), high PASP (≥45mmHg) (OR = 15.914), anemia (OR = 7.693), atrial fibrillation (OR = 6.215) and ICU admission Independent risk factors for hospitalized death. Conclusions High mortality, pneumonia, high PASP (≥45 mmHg), anemia, atrial fibrillation and ICU admission are the independent risk factors for in-hospital mortality in AECOPD patients.