Identification and analysis of risk factors for ventilator-associated pneumonia in elderly patients in neurology department
Objective To investigate and analyze the risk factors of ventilator-associated pneumonia(VAP)in elderly patients in the neurology intensive care unit(NCU),and explore relevant prevention and control strategies to reduce its incidence.Method A retrospective investigation was conducted on 245 elderly patients(≥65 years old)who received ventilation in NCU for more than 48 hours from January 1,2020 to December 31,2022 in the First Affiliated Hospital of Anhui Medicial University,and the risk factors and types of pathogens were analyzed.Results Among the 245 patients who have used ventilators,67 developed VAP,and the infection rate was 27.34％.Multivariate logistic regression showed that VAP was associated with intracranial hemorrhage(OR=5.790,95％CI:2.190-15.309),antibiotic use for more than 7 days(OR=12.438,95％CI:1.474-104.948)and ventilator use for more than 5 days(OR=16.105,95％CI:5.288-49.047),the differences were statistically significant(all P＜0.05).A total of 21 pathogens were isolated from sputum samples or bronchoalveolar lavage fluid of 67 VAP infected patients,with 112 pathogenic microorganisms.The main pathogens were Acinetobacter baumannii,Klebsiella pneumoniae and Pseudomonas aeruginosa,accounting for 29.46％,17.86％and 14.29％respectively.Conclusion VAP was common among elderly patients in NCU;the risk factors include intracranial hemorrhage,duration of antimicrobial treatment and duration of ventilator use,and the infection pathogens were mostly Gram-negative bacteria.
Neurology intensive care unitElderly patientsVentilator-associated pneumoniaPathogens
NETL
NSTL
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