Epidemiological characteristics and risk prediction model of pulmonary infection in elderly patients in a hospital in Hebei Province / 公共卫生与预防医学

ABSTRACT

Objective To analyze the epidemiological characteristics and influencing factors of pulmonary infection in the elderly, and to construct a risk prediction model. Methods Stratified cluster sampling was used to randomly select 683 elderly patients in Zhangjiakou First Hospital as the investigation subjects. Sputum specimens were collected and sent for bacterial isolation, culture, identification, and drug sensitivity test. According to whether the patients had pulmonary infection, they were divided into pulmonary infection group (n=315) and non-pulmonary infection group (n=368). The clinical data of the two groups such as age, sex, COPD, and ICU admission were analyzed. Univariate analysis and logistic regression analysis were used to analyze the influencing factors of pulmonary infection in elderly patients, and a risk prediction model was established. Results A total of 331 strains of pathogenic bacteria were detected in 315 patients with pulmonary infection, and there were 207 strains (62.54%) of gram-negative bacteria detected, mainly including 95 strains (28.70%) of Acinetobacter baumannii and 71 strains (21.45%) of Klebsiella pneumoniae. There were 169 strains (26.28%) of gram-positive bacteria detected, mainly 68 strains (20.54%) of Staphylococcus aureus. In addition, there were 25 strains of fungi (7.55%). There were no significant differences in gender, smoking history, history of COPD, asthma, and stroke between the two groups (P>0.05). The proportion of patients aged≥70, mechanical ventilation, admission to ICU and recent respiratory tract infection in the experimental group was significantly higher than that in the control group (P<0.05). Multivariate logistic regression analysis showed that age, smoking history, mechanical ventilation, and ICU admission were independent risk factors for pulmonary infection in elderly patients (P<0.05). According to the above four independent influencing factors and corresponding regression coefficient of each factor, the prediction model of pulmonary infection in elderly patients was constructed, Z=-5.948+1.198× (age) +1.281×(smoking history) +2.029×(mechanical ventilation) +1.211×(ICU admission). Conclusion Lung infection in elderly patients in our hospital is dominated by gram-negative bacilli. Antibiotics should be rationally selected according to drug sensitivity results. Age≥70 years old and COPD can increase the risk of pulmonary infection in elderly patients, and the prediction model constructed can effectively predict the occurrence of pulmonary infection in elderly patients.