Analysis of clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture after the treatment through a model of orthopedic-geriatric co-care,in order to provide prevention and control strategies.Methods Clinical data and laboratory results of elderly patients with hip fractures admitted into our hospital from January 2016 to May 2016 were collected.The differences in treatment outcome and adverse reactions were retrospectively compared between the two groups of patients with versus without pulmonary infection,and univariate and multivariate analysis of lung infection were performed.Results Of 207 patients,43 were infected with pneumonia and 164 were not.The proportion of patients with the time interval＜48 h from admission to surgery was 48.6％ (86/177),and the time interval＜ 1 week from admission to surgery was 98.9％ (175/177).The average length of hospital stay was(7.9±3.5)days.There was no significant difference in the time interval from admission to surgery,the time spent on surgery,length of hospital stay,surgical procedure and inflammatory indicators between the pneumonia and non-pneumonia groups.Univariate analysis showed that advanced age,multiple primary diseases,primary lung diseases,chronic respiratory failure,cerebrovascular disease,sequelae of cerebrovascular disease,immune system disease or long-term oral hormone therapy and preoperative anemia were risk factors for pulmonary infection in elderly patients with hip fracture (P ＜ 0.05 or＜ 0.01).Multivariate regression analysis showed that advanced age(OR =1.239,95％ CI1.016 ～ 1.595,P =0.051),preoperative anemia(OR =2.491,95％ CI1.148～ 5.403,P =0.021),sequelae of cerebrovascular disease (OR =3.987,95％ CI1.354 ～11.741,P=0.012),primary lung diseases(OR =4.404,95％ CI1.800 ～ 11.078,P =0.001) and immune system diseases (OR =17.166,95 ％ CI1.750 ～ 168.409,P =0.015) were independent risk factors for pulmonary infection in elderly patients with hip fracture.Conclusions The orthopedic-geriatric co-care model seems to be in favour of controlling the progress of pulmonary infection in elderly patients with hip fracture,and to shorten waiting time before surgery and length of hospital stay.However,advanced age and chronic diseases are unpreventable risk factors for pulmonary infection in elderly patients with hip fractures.Clinicians should pay attention to the high-risk population and take prevention and control strategies to prevent the occurrence and development of lung infections.