Case Control Study on Risk Factors of Nosocomical Pneumonia in Elderly in-Patients_Chinese Journal of Evidence-Based Medicine

Authors：

OU Xuemei , DONG Birong , YUE Jirong

Department of Geriatrics; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Noesocomical pneumonia; Risk factors; Eldely; Case control study

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Objective 　To define risk factors of nosocomical pneumonia (NP) in elderly in-patients.
Methods 　Two hundred elderly in-patients were selected in the Geriatric Department of West China Hospital from January 1999 to June 2002. Among them, 100 patients developed NP during their hospital days and the others didn’t have the episodes of NP at the same time. The following factors were analyzed: sex, age, multiple underline diseases and their severity, smoking, activity of daily life, conscious status, aspiration, nasogastrial intubations, antibiotics use and hospitalization. SPSS 10.0 was used for Logistic regression analysis to determine the factors significantly associated with the development of NP.
Results 　The following factors were significantly associated with the development of NP in the logistic regression analysis: aspiration [OR 28.452, 95%CI (3.793 to 213.447)],multiple diseases [OR 17.157, 95%CI (2.734 to 107.651)], multiple antibiotics use [OR 6.396, 95%CI (1.861 to 21.980)], smoking [OR 1.774, 95%CI (1.211 to 2.600)] and prolonged hospitalization [OR 1.134, 95%CI (1.081 to 1.189)].
Conclusions 　Aspiration, multiple diseases, multiple antitiotics use, smoking and prolonged hospitalization are closely related to NP in elderly in-patients. Cautionary medical measures and shortening hospitalization were the key factors to decrease the incidence of NP for the patients in Geriatric Department.

Citation： OU Xuemei,DONG Birong,YUE Jirong. Case Control Study on Risk Factors of Nosocomical Pneumonia in Elderly in-Patients. Chinese Journal of Evidence-Based Medicine, 2004, 04(5): 310-313. doi: Copy

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1. ［1］Hu BJ, He LX, Zhang XY, Dong WX, Li XY. Epidemiology of Nosocomial Pneumonia in China: Meta-analysis for Literature Published in 1990s[J]. Chin J Nosocomiol, 2001;11(3) :177 -180.
2. 胡必杰,何礼贤,张庆怡,董伟贤,李锡蓉.我国医院院内肺炎流行病学现状:20世纪90年代发表论文的荟萃分析.中华医院感染杂志,2001;11(3):177～180.
3. ［2］Zhu YL. Rehabilitation Medicine of Nervous System [ M ].Beijing: People Surgeon Press. 2001:183 - 184.
4. 朱镛连.神经康复学[M].北京:人民军医出版社,2001:183～184.
5. ［3］Daniels SK, Brailey K, Priestly DH, Herrington LR, Weisberg LA, Foundas AL. Aspiration in patients with acute stroke[J]. Arch Phys Med Rehabil, 1998; 79(1) :14-19.
6. ［4］Yamaya M, Yanai M, Ohrui T, Arai H, Sekizawa K, Sasaki H. Interventions to prevent pneumonia among older adult[J]. J Am Geriatr Soc, 2001; 49 ( 1 ): 85 - 90.
7. ［5］Schonhofer B, Barchfeld T, Haidl P, Kohler D. Scintigraphy for evaluation early aspiration after feeding in patients receiving prolonged ventilation tracheostomy [J ]. Intensive Care Med,1999; 120(4) :474 -478.
8. ［6］Lader SB, Sasaki CT, Burrell MI. Fiberoptic endoscopic evaluation of dysphagia to silent aspiration [J ]. Dysphagi,1998; 13(1) :19 -21.
9. ［7］Johanson WGJr, Pierce AK, Sanford Jp, Thomas GD.Nosiocomial respiratory infections with gram-negatire hadilli:the significance of colonization of the respiratory tract. Ann Intern Med, 1972;77:701 -706.
10. ［8］Finucane TE, Bynum Jp. Use of tube feeding to prevent aspiration pneumonia[ J ]. Lancet, 1996; 348:1 421 - 1 424.
11. ［9］Joshi N, Locallio AR, Hamory BH. A predictive risk index for nosocomial in the intensive care unit [ J ]. Am J Med,1992; 93:135 - 142.

Chinese Journal of Evidence-Based Medicine

Case Control Study on Risk Factors of Nosocomical Pneumonia in Elderly in-Patients

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