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Objective To assess the risk factors associated with nosocomial infection in patients with non-surgical basal ganglia intracranial hemorrhage (ICH) in the acute phase to provide evidence for prevention and intervention of nosocomial infections.Methods Clinical data of 224 patients with nonsurgical basal ganglia ICH from January 2014 to December 2018 in the Shenzhen People's Hospital were analyzed.Patients were divided into 2 groups based on the presence or absence of infection.Clinical data between the two groups were compared including gender,age,past medical history,bleeding volume,hematoma growth rate,systolic blood pressure,diastolic blood pressure,GCS,NIHSS,WBC,RBC,FBI,PLT,CR,BUN,GLU,CRP,UA,CHOL,TG,LDL,HCY.Multivariate Logistic regression analysis and the area under the ROC curve were performed on meaningful variables (P ＜ 0.05) to determine the early independent predictors of risk factors for nosocomial infections.ResuIts Nosocomial infection occurred in 47 of 224 patients,with an infection rate of 20.98％.Compared with infected group,non-infected group had a higher value of age [(63.91 ± 12.37) years vs.(58.66 ± 12.37) years,P =0.010],bleeding volume [(10.33 ± 7.94) ml vs.(7.61 ± 6.58) ml,P=0.034],hematoma growth rate [(7.34 ± 9.17) ml/h vs.(4.33 ± 6.77) ml/h,P=0.040],systolic blood pressure [(177.94 ± 25.28) mmHg (1 mmHg=0.133 kPa)vs.(164.85 ± 22.34) mmHg,P=0.001],NIHSS score [(7.89 ± 4.92) scores vs.(4.84 ± 4.59) scores,P＜0.01],WBC [(9.50 ± 3.23) × 109/L vs.(8.25 ± 2.28) × 109/L,p=0.015],FBI [(3.44 ± 0.95) g/L vs.(3.03 ± 0.63) g/L,P =0.007],BUN [(7.01 ± 5.84) mmol/L vs.(4.95 ± 1.93) mmol/L,P =0.021],GLU [(7.27 ± 2.84) mmol/L vs.(5.96 ± 1.75),P =0.004] and CRP [(11.94 ± 21.4) mg/L vs.(4.39 ± 6.41) mg/L,P=0.021].Multivariate Logistic regression analysis showed that systolic blood pressure (OR=1.021,95％ CI 1.005-1.037,P=0.012),NIHSS score (OR=1.143,95％ CI 1.056-1.237,P=0.001),BUN (OR=1.174,95％ CI 1.025-1.344,P=0.020),CRP (OR=1.063,95％ CI 1.016-1.112,P=0.008) and age (OR=1.053,95％CI 1.019-1.089,P=0.002) was an independent risk factor for nosocomial infection in non-surgical basal ganglia ICH patients in the acute phase.The Area Under Curve (AUC) of the above independent risk factors was calculated,and the results showed that systolic blood pressure (AUC =0.653,95％ CI 0.564-0.741,P =0.001),NIHSS score (AUC =0.679,95％ CI 0.592-0.767,P =0.000),BUN (AUC =0.617,95％ CI 0.526-0.708,P =0.014),CRP (AUC =0.691,95％ CI 0.614-0.768,P =0.000) and age (AUC =0.643,95％ CI 0.557-0.728,P =0.003) had an early predictive value for the occurrence of nosocomial infection in non-operative basal ganglia ICH patients in the acute stage.Conclusions The occurrence of nosocomial infections has identifiable and early predictive risk factors in patients with non-surgical basal ganglia ICH during acute phase.Therefore,controllable risk factors need to be controlled to reduce the incidence of nosocomial infections.
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Objective@#To assess the risk factors associated with nosocomial infection in patients with non-surgical basal ganglia intracranial hemorrhage (ICH) in the acute phase to provide evidence for prevention and intervention of nosocomial infections.@*Methods@#Clinical data of 224 patients with non-surgical basal ganglia ICH from January 2014 to December 2018 in the Shenzhen People′s Hospital were analyzed. Patients were divided into 2 groups based on the presence or absence of infection. Clinical data between the two groups were compared including gender, age, past medical history, bleeding volume, hematoma growth rate, systolic blood pressure, diastolic blood pressure, GCS, NIHSS, WBC, RBC, FBI, PLT, CR, BUN, GLU, CRP, UA, CHOL, TG, LDL, HCY. Multivariate Logistic regression analysis and the area under the ROC curve were performed on meaningful variables (P<0.05) to determine the early independent predictors of risk factors for nosocomial infections.@*ResuIts@#Nosocomial infection occurred in 47 of 224 patients, with an infection rate of 20.98%. Compared with infected group, non-infected group had a higher value of age [(63.91 ± 12.37) years vs. (58.66 ± 12.37) years, P=0.010], bleeding volume [(10.33 ± 7.94) ml vs. (7.61 ± 6.58) ml, P=0.034], hematoma growth rate [(7.34 ± 9.17) ml/h vs. (4.33 ± 6.77) ml/h, P=0.040], systolic blood pressure [(177.94 ± 25.28) mmHg (1 mmHg=0.133 kPa) vs. (164.85 ± 22.34) mmHg, P=0.001], NIHSS score [(7.89 ± 4.92) scores vs. (4.84 ± 4.59) scores, P<0.01], WBC [(9.50 ± 3.23) × 109/L vs. (8.25 ± 2.28) × 109/L, P=0.015], FBI [(3.44 ± 0.95) g/L vs. (3.03 ± 0.63) g/L, P=0.007], BUN [(7.01 ± 5.84) mmol/L vs. (4.95 ± 1.93) mmol/L, P=0.021], GLU [(7.27 ± 2.84) mmol/L vs. (5.96 ± 1.75), P=0.004] and CRP [(11.94 ± 21.4) mg/L vs. (4.39 ± 6.41) mg/L, P=0.021]. Multivariate Logistic regression analysis showed that systolic blood pressure (OR=1.021, 95% CI 1.005 -1.037, P=0.012), NIHSS score (OR=1.143, 95% CI 1.056 - 1.237, P=0.001), BUN (OR=1.174, 95% CI 1.025 - 1.344, P=0.020), CRP (OR=1.063, 95% CI 1.016 - 1.112, P=0.008) and age (OR=1.053, 95%CI 1.019 -1.089, P=0.002) was an independent risk factor for nosocomial infection in non-surgical basal ganglia ICH patients in the acute phase. The Area Under Curve (AUC) of the above independent risk factors was calculated, and the results showed that systolic blood pressure (AUC=0.653, 95% CI 0.564 -0.741, P=0.001), NIHSS score (AUC=0.679, 95% CI 0.592 - 0.767, P=0.000), BUN (AUC=0.617, 95% CI 0.526 - 0.708, P=0.014), CRP (AUC=0.691, 95% CI 0.614 - 0.768, P=0.000) and age (AUC=0.643, 95% CI 0.557 - 0.728, P=0.003) had an early predictive value for the occurrence of nosocomial infection in non-operative basal ganglia ICH patients in the acute stage.@*Conclusions@#The occurrence of nosocomial infections has identifiable and early predictive risk factors in patients with non-surgical basal ganglia ICH during acute phase. Therefore, controllable risk factors need to be controlled to reduce the incidence of nosocomial infections.
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Objective To investigate the outpatient visitor′s B19 infection in Fuzhou area, study the correlation between B19 virus infection and clinical diseases.Methods The infection status of B19V IgM and IgG in 22 089 outpatient visitors in Fuzhou area from 2011 to 2016 has been retrospectively analyzed.The patients were divided into different groups according to sex,age,different pregnant outcomes, healthy people and hematopoietic system diseases.Results The positive rate in 22 089 patients of B19V IgM was 4.5%(998/22 089)and the IgG positive rate was 36.9%(8 155/22 089); The positive rate of B19V IgM in female patients(4.8%,546/11 374)was higher than male patients(4.2%,452/10 715)(χ2=4.333,P<0.05); The middle-aged and elderly patients IgG positive rate(53.6%,3 629/6 772;54.3%,1 542/2 838)were significantly higher than infants,children and young people(36.0%,989/2 747;25.4%,237/934;20.0%,1 758/8 797); The positive rate of IgM in adverse pregnancy outcomes (8.2%,20/245)was higher than normal pregnant women(3.3%,23/688)(χ2=9.548,P<0.05).In pancytopenia,thrombocytopenia and anemia patients, the positive rates of B19V IgG were 39.8%(165/415),38.1%(297/780)and 35.4%(81/226)respectively, all of which were higher than that in the healthy people(14.4%,78/543)(χ2=80.127,88.626,43.461; P<0.05).Conclusions The outpatient visitor′s infection rate of B19V in Fuzhou is high.B19V is a common virus who can lead to adverse pregnancy outcomes.What′s more, it also can lead to pancytopenia, thrombocytopenia, anemia or other related hematopoietic diseases.
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Objective To evaluate the correlation between serum uric acid with cognitive disorder after acute cere?bral infarction by prospective study. Methods Four hundred consecutively enrolled patients of acute cerebral infarction were divided into no cognitive impairment group and cognitive impairment group according to the assess of Montreal Cog?nitive Assessment (MoCA). Univariate analysises were conducted in the potential risk factors of cognitive impairment in?cluding age, sex, smoking, alcohol, hypertension, diabetes, dyslipidemia, level of education, infarction in key parts, atrial fibrillation, serum uric acid, blood homocysteine between two groups. The statistically significant indicators in univariate analysises were used as independent variables and the scores of MoCA were used as the dependent variable to conduct multiple linear regression analysis. The assessment on the risk of cognitive impairment after cerebral infarction were con?ducted according to serum uric acid, sex, age and TOAST classification further. Results Serum uric acid was indepen?dent risk factors of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level and the relative risk was 1.35,95%CI(1.098,1.660). Especially for the young, male or patients with cerebral infarction in classification of small artery occlusion, the risk increased further, and the relative risk was 1.513, 95%CI(1.092, 2.096)1.412, 95%CI (1.125, 1.771)and 1.464, 95%CI(1.128, 1.900)respectively. Conclusion Exaltation of Serum uric acid was indepen?dent risk factor of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level, and especially for the young, male and patients with cerebral infarction in classification of small artery occlusion, the risk increased fur?ther.