老年多器官衰竭发病危险因素的临床分析

摘要

目的：探讨老年多器官衰竭（ MOFE）发病的危险因素。方法入选2013年1月至2016年2月期间上海交通大学附属瑞金医院卢湾分院老年科、重症监护病房、心血管内科、神经内科及消化内科收治住院的老年患者656例，依据是否发生MOFE分为两组：MOFE组（n＝280）和非MOFE组（n＝376）。收集患者的临床资料，了解发病前患者慢性基础疾病的情况。通过逐步logistic回归分析筛选MOFE 发病的独立危险因素。结果 MOFE发病前患者一般均存在≥2种慢性疾病。慢性心功能不全、慢性呼吸衰竭、脑血管疾病、肾功能不全和糖尿病是影响MOFE发病的独立危险因素。结论慢性基础疾病是发生MOFE的重要病理基础，对于存在危险因素的老年患者，应加强对相关慢性疾病的治疗，积极保护和改善各脏器功能，从而降低MOFE的发生率和病死率。%Objective To investigate the risk factors for multiple organ failure in the elderly ( MOFE) .Methods A total of 656 patients who were admitted to the geriatric , cardiovascular , neurological and gastroenterological departments and intensive care unit of our hospital from January 2013 to February 2016 were enrolled in this study.They were divided into MOFE group (n=280) and non-MOFE group ( n=376 ) .Their general information , clinical data and comorbidity of chronic diseases were collected and surveyed . Stepwise logistic regression analysis was used to screen the independent risk factors for MOFE .Results Before the onset, the MOFE patients had at least ≥2 kinds of chronic diseases .Chronic heart failure , chronic respiratory failure , cerebrovascular disease , renal insufficiency and diabetes mellitus were independent risk factors for MOFE .Conclusion Chronic underlying disease is an important pathological basis of MOFE .For the patients who have above risk factors , the treatment to chronic underlying diseases need to be strengthened to actively protect and improve the function of viscera , so as to prevent the occurrence and mortality of MOFE .