广州市中老年社区获得性肺炎住院患者特征及住院时长的影响因素研究

摘要

目的 分析广州市中老年社区获得性肺炎住院患者的流行病学特征、基础疾病及诊治情况,并探讨影响其住院时长的因素.方法 收集广州市6家综合三甲医院≥40岁中老年社区获得性肺炎患者的病历资料,采用回顾性病例分析其流行病学特征、基础疾病及诊治情况,通过logistic多元回归模型探讨患者住院时长的影响因素.结果 共纳入6 231例中老年社区获得性肺炎患者,平均年龄(69.87±12.32)岁,其中男性3 583例(57.5％),基础疾病以高血压(31.8％)、糖尿病(16.6％)、慢性阻塞性肺疾病(11.3％)较多.病原学检查结果显示细菌(25.4％)及真菌(14.9％)感染较多,97.7％患者接受了抗生素治疗.多因素非条件logistic回归分析结果发现,年龄(OR=1.005,95％CI:1.001 ～ 1.009)、吸烟史(OR=1.292,95％CI:1.159～1.441)、肿瘤(OR=1.217,95％CI:1.022 ～ 1.449)、充血性心力衰竭(OR=1.323,95％CI:1.076～1.626)、使用糖皮质激素(OR=1.744,95％CI:1.545 ～ 1.969)及转入ICU(0R=2.724,95％CI:2.031 ～ 3.654)为广州市中老年社区获得性肺炎患者住院时长的影响因素.结论 广州市中老年社区获得性肺炎患者常有多种基础疾病,以高血压、糖尿病等较为常见,年龄、吸烟史、肿瘤、充血性心力衰竭、使用糖皮质激素及转入ICU等为患者住院时长的影响因素.%Objective To investigate the characteristics,underlying patterns of disease and treatments on middle-aged and elderly patients who suffered from community-acquired pneumonia (CAP) and factors related to the duration of hospitalization of this disease.Methods Descriptive study was conducted to depict the characteristics,underlying disease patterns and treatments on patients who were older than 40 years of age.Data was collected through medical records of the patients,retrospectively.Multivariate logistic regression analysis was conducted to explore those factors that affecting the duration of hospitalization.Results A total of 6 231 cases,with 3 583 (57.5％) males were involved.Mean age of the patients was 69.87± 12.32.Underlying diseases would include hypertension (31.8％) and diabetes (16.6％),with most pathogens bacteria (25.4％) or fungus (14.9％) related.97.7％ of the patients received antibiotics.Factors as age (OR=1.005,95％ CI:1.001-1.009),smoking habit (OR=1.292,95％ CI:1.159-1.441),tumor (OR=1.217,95％ CI:1.022-1.449),congestive heart failure (OR=1.323,95％CI:1.076-1.626),glucocorticoid treatment (OR=1.744,95％CI:1.545-1.969) and ICU admission (OR=2.724,95％CI:2.031-3.654) were significantly related to the duration of hospitalization.Conclusions Patients above the age of 40 who suffered from community-acquired pneumonia were often accompanied by underlying diseases.Factors as age,smoking habit,tumor,congestive heart failure,glucocorticoid treatment and ICU admission would affect the duration of hospitalization.