Distribution characteristics of ABA in elderly people with COPD and pulmonary infection in Shaanxi and logistic analysis of the influencing factors on the prognosis / 公共卫生与预防医学

ABSTRACT

Objective To investigate the distribution characteristics of ABA (Acinetobacter baumannii) and to analyze the influencing factors of the prognosis of elderly patients with COPD (chronic obstructive pulmonary disease) and lung infection in Shaanxi. Methods A retrospective single-center survey was conducted on 1 078 elderly patients with COPD admitted to our hospital from January 2015 to November 2019. According to the presence or absence of ABA infection, the patients were divided into infection group (n=63) and non-infection group (n=1 015). Through the electronic medical record system, the basic information of all patients was collected, including name, sex, age, case number, length of stay in ICU, index of auxiliary examination, combined diseases and prognosis. The prognostic outcomes of the two groups of patients were compared. Univariate analysis was performed on the baseline data of the two groups of the patients, and unconditional logistic multivariate regression analysis was used to further analyze the single factors with statistical difference, to explore the distribution and influencing factors of ABA in elderly COPD patients with pulmonary infection in Shaanxi. Results The mortality rate of the infected group was significantly higher than that of the non-infected group (χ2=8.670, P=0.003). Univariate analysis showed that there were significant differences in age, Apache II score, diabetes, PCT and ICU length of stay between the infected and non-infected groups (P<0.05), while there were no significant differences in sex, cerebrovascular disease, malnutrition, bed rest and tumor (P<0.05). In the infection group, 55 patients survived, 42 patients were discharged, 13 patients received extended hospitalization and 8 patients died. Of those who died, 5 were resistant to cefoperazone and all were resistant to carbapenems. Of those remaining hospitalized, 3 patients were resistant to cefoperazone sulbactam and 7 were resistant to carbapenems. Patients discharged from the hospital were more sensitive to carbapenems, minocycline and cefoperazone. According to multiple logistic regression analysis, apache II score (OR=3.480，95%CI 1.154-10.491), diabetes mellitus (OR=2.732，95%CI 1.297-5.753), high serum PCT (OR=6.334，95%CI 1.142-35.129) and ICU hospitalization (OR=3.773，95%CI 1.087-13.100) were independent risk factors influencing the prognosis of elderly patients with COPD in Shaanxi. Conclusion ABA Infection was correlated with age, Apache II score, diabetes Mellitus, PCT and length of stay in ICU, which could influence prognosis of elderly patients with COPD.