Analysis of the reasons for elderly patients with severe pneumonia returning to ICU and prognostic factors
Objective To explore the reasons for elderly patients with severe pneumonia returning to intensive care unit(ICU)and to analyze the prognostic factors.Methods A total of 300 elderly patients with severe pneumonia admitted from January 2020 to April 2023 were selected.All patients had improved conditions after the initial ICU treatment and they were transferred to the general ward for further treatment.Among them,19 patients returned to the ICU due to worsening conditions,while the remaining 281 patients did not return to the ICU.Clinical conditions,including age,gender ratio,blood transfusion,the Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score,length in ICU,comorbidities,aspiration after transferring to wards,delirium and cough weakness after transferring to wards were compared between groups.Influencing factors of elderly patients returning to ICU were analyzed.Prognosis of elderly patients returning to the ICU was observed.Clinical data of death cases and survivors were compared and the prognostic factors were explored.Results There were significant differences in blood transfusion,length in ICU,APACHE Ⅱ score before transferring to wards,complication of diabetes,aspiration and delirium after transferring to wards between patients who returned to ICU and those who did not return to ICU(P＜0.05).Multivariate logistic regression analysis showed that the independent risk factors of elderly patients with severe pneumonia returning to ICU were APACHE Ⅱ score before transferring to wards,length in ICU,diabetes,aspiration after transferring to wards,and delirium after transferring to wards(P＜0.05).There were significant differences in APACHE Ⅱ score,length in ICU,diabetes,aspiration after transferring to wards,and delirium after transferring to wards between dead cases and survivors returning to ICU(P＜0.05).Multivariate logistic regression analysis showed that the independent risk factors influencing the prognosis of elderly patients with severe pneumonia returning to ICU were APACHE Ⅱscore,length in ICU,diabetes,aspiration and delirium after transferring to wards(P＜0.05).Conclusion The reasons for the elderly patients with severe pneumonia returning to the ICU and the factors affecting the prognosis of the patients returning to the ICU are complex.Clinically,it is necessary to attach a great importance to the treatment and intervention of patients with high APACHE Ⅱ score,long length in ICU,diabetes,aspiration and delirium after transferring to wards,so as to reduce the incidence of returning to the ICU as much as possible and improve the prognosis of patients returning to the ICU.
elderlypneumoniaintensive care unit(ICU)prognosisinfluence factor
NETL
NSTL
万方数据
维普
