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目的探讨医院下呼吸道感染的危险因素。方法对2010—2012年的住院患者进行回顾性研究,309例发生下呼吸道感染患者为病例组,未感染者根据住院科室相同、入院日期相近(±10 d)的配比条件按1∶1作为对照组,采用单因素分析和多因素Cox回归分析下呼吸道感染的危险因素,P<0.05为差异有统计学意义。结果对患者方面可能的危险因素进行单因素分析,年龄(OR=1.536,95%CI为1.204~1.959),入院情况为急(OR=2.356,95%CI为1.588~3.495)、重(OR=4.050,95%CI为2.387~6.871)、危(OR=3.280,95%CI为2.038~5.279),低蛋白血症(OR=1.973,95%CI为1.496~2.602),昏迷时间(OR=1.966,95%CI为1.478~2.616),出院诊断的疾病种类(OR=4.553,95%CI为2.863~7.243),住院最高体温(OR=1.336,95%CI为1.223~1.449),白细胞数(OR=1.511,95%CI为1.205~1.895),基础疾病严重程度为严重(OR=3.719,95%CI为2.349~5.888)、危重(OR=4.021,95%CI为2.375~6.810),高血压(OR=1.357,95%CI为1.084~1.697),脑血管意外(OR=1.486,95%CI为1.188~1.859),脏器衰竭(OR=1.449,95%CI为1.043~2.013)等11个因素会增加下呼吸道感染的危险性,差异均有统计学意义(均P<0.05);再对这11个变量进行Cox回归分析,结果表明基础疾病严重程度(OR=1.682,95%CI为1.417~1.997)、出院诊断的疾病种类(OR=2.412,95%CI为1.474~3.950)和住院最高体温(OR=1.204,95%CI为1.081~1.341)是下呼吸道感染的独立危险因素。结论控制医院下呼吸道感染,应针对危险因素,采取相应的预防措施,从而控制和减少感染的发生。
Objective To investigate the risk factors of lower respiratory tract infection in hospitals. Methods A retrospective study was conducted on inpatients from 2010 to 2012. 309 patients with lower respiratory tract infection were selected as case group. According to the same inpatient department and similar admission date (± 10 d), the proportion of uninfected patients was 1: 1 Control group, univariate analysis and multivariate Cox regression analysis of risk factors for lower respiratory tract infection, P <0.05 for the difference was statistically significant. Results The univariate analysis of the possible risk factors in patients was made. The age (OR = 1.536, 95% CI 1.204 to 1.959), hospital admission was urgent (OR = 2.356, 95% CI 1.588-3.495) 4.050, 95% CI 2.387-6.871), risk (OR = 3.280, 95% CI 2.038-5.279), hypoproteinemia (OR = 1.973, 95% CI 1.496-2.602), coma time , 95% CI 1.478-2.616), the type of disease (OR = 4.553,95% CI 2.863-7.243), the highest hospitalization temperature (OR = 1.336, 95% CI 1.223-1.449), the number of white blood cells = 1.511, 95% CI was 1.205-1.895). The severity of underlying diseases was severe (OR = 3.719, 95% CI 2.349-5.888), critical (OR = 4.021, 95% CI 2.375-6.810) OR = 1.357, 95% CI: 1.084-1.697), 11 factors including cerebrovascular accident (OR = 1.486, 95% CI 1.188-1.859), organ failure (OR = 1.449, 95% CI 1.043-2.01) (P <0.05). The Cox regression analysis of these 11 variables showed that the underlying disease severity (OR = 1.682, 95% CI 1.417 ~ 1.997), the type of disease (OR = 2.412,95% CI 1.474 ~ 3.950) and the highest body temperature in hospital (OR = 1.204, 95% CI 1.081-1). 341) is an independent risk factor for lower respiratory tract infection. Conclusions In order to control the lower respiratory tract infection in hospital, appropriate preventive measures should be taken according to the risk factors so as to control and reduce the incidence of infection.