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目的分析老年住院严重急性呼吸道感染(SARI)病例流行特征,探讨影响转归的危险因素。方法舟山市2011年3月—2014年2月确诊老年SARI病例按不同转归进行分组,分析病例特征,并进行Logistic多因素分析。结果 251例SARI确诊病例中,好转组236例,未愈组15例。两组病例在住院期间临床表现既往史的单因素统计分析表明,气促发生率未愈组为86.67%,高于好转组的47.46%;有癌症疾病史比例未愈组为53.33%,高于好转组的14.41%;并发症中肾功能损害的比例和DIC发生率未愈组分别为13.33%和13.33%,均高于好转组(1.69%和0.42%)(P<0.05)。多因素Logistic回归分析显示,有癌症疾病史、临床表现有气促和并发DIC为影响转归的危险因素,其OR值(95%CI)分别为11.79(3.44~40.37)、8.01(1.64~39.19)和44.55(3.42~581.15)。结论应对有气促表现和癌症史的老年SARI患者加强监护,防止DIC的出现。
Objective To analyze the epidemiological characteristics of elderly hospitalized patients with severe acute respiratory infection (SARI) and to explore the risk factors influencing prognosis. Methods March to February 2014 in Zhoushan City The diagnosis of elderly SARI cases were divided into different groups according to different prognosis. The case characteristics were analyzed and analyzed by Logistic multivariate analysis. Results Of the 251 SARI confirmed cases, 236 cases were improved and 15 cases were unhealed. The two groups of patients in the hospital during the past clinical manifestations of univariate statistical analysis showed that the incidence of breathless rate was 86.67% unhealed, higher than the improved group 47.46%; the proportion of patients with a history of cancer disease unhealed 53.33%, higher than (14.41%) in the remission group. The rate of renal dysfunction and DIC in the uncomplicated group were 13.33% and 13.33%, respectively, which were higher than those in the improvement group (1.69% and 0.42%, P <0.05). Multivariate logistic regression analysis showed that there was a history of cancer, clinical manifestations of breathlessness and concurrent DIC as risk factors for prognosis. The OR values (95% CI) were 11.79 (3.44-40.37), 8.01 (1.64-39.19 ) And 44.55 (3.42 ~ 581.15). Conclusion The elderly patients with SARS who have a history of shortness of breath and cancer should be monitored intensively to prevent the appearance of DIC.