Analysis of etiological characteristics and related factors of elderly chronic heart failure complicated with pulmonary infection
Objective To explore the etiological characteristics and related risk factors of elderly patients with chronic heart failure complicated with pulmonary infection,so as to provide a basis for clinical prevention and treatment.Methods The 87 elderly patients with chronic heart failure complicated with pulmonary infection admitted to our hospital were selected and analyzed as the research objects in this study,and sputum specimens were collected for pathogen identification.The levels of serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)in patients were measured,and the levels of serum inflammatory factors were compared in patients with different cardiac function grades.The geriatric nutritional risk index of patients measured to analyze the correlation between the nutritional risk index and pulmonary infection.The clinical data of patients were analyzed retrospectively and the related factors of elderly chronic heart failure complicated with pulmonary infection were analyzed comparatively.Results Among 87 elderly patients with heart failure complicated by pulmonary infection,a total of 91 strains of pathogenic bacteria were isolated.Among them,Gram-negative bacteria accounted for 68.13％,mainly Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,etc.Gram-positive bacteria accounted for 28.57％,mainly Streptococcus pneumoniae and Staphylococcus aureus.Fungal infections accounted for 3.30％,all of which were Candida albicans.The levels of serum IL-6,CRP and PCT in patients with cardiac function grade Ⅰ-Ⅱ were(9.58±2.06)pg/mL,(58.94±18.65)mg/L and(0.98±0.33)µg/L respectively;the corresponding levels in patients with cardiac function grade Ⅲ-Ⅳ were(11.86±2.47)pg/mL,(70.11±14.26)mg/L and(1.18±0.23)μg/L respectively.There were significant differences in relevant indicators between the two groups(P＜0.05).The average GNRI score of patients in the pulmonary infection group was(86.48 11.56),which was divided into no risk(17.24％),mild risk(19.54％),moderate risk(32.18％)and severe risk(31.03％).The average GNRI score of patients in the control group was(97.62 15.44),which was divided into no risk(38.57％),mild risk(18.57％),moderate risk(31.43％)and severe risk(11.43％).There were significant differences in GNRI scores and the composition ratios of nutritional risk levels between the two groups(P＜0.05).By analyzing the data of patients with pulmonary infection and the control group,it was found that age,cardiac function,diabetes,chronic obstructive pulmonary disease,bed-rest time,and invasive operations showed significant differences between the two groups(P＜0.05),while gender,smoking history,coronary heart disease,renal insufficiency,and length of hospital stay showed no significant differences(P＞0.05).Further analysis showed that age≥70 years old,cardiac function grade Ⅲ-Ⅳ,diabetes,chronic obstructive pulmonary disease,bed-rest time≥24 months,and invasive operations were independent risk factors for pulmonary infection in elderly patients with heart failure(P＜0.05).Conclusion The main pathogenic bacteria in elderly patients with chronic heart failure complicated with pulmonary infection were Gram-negative bacteria,mainly K.pneumoniae and P.aeruginosa.The higher the cardiac function grade of the patients,the higher the levels of serum IL-6,CRP and PCT.The geriatric nutritional risk index was positively correlated with the severity of pulmonary infection,indicating that the deterioration of nutritional status may increase the risk of infection.Taking corresponding preventive measures for the identified independent risk factors was of great significance for improving the prognosis of patients.
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