Analysis of factors influencing the prognosis of ventilator-associated pneumonia
Objective To analyze the factors influencing the prognosis of ventilator-associated pneumonia(VAP).Methods 107 patients who were first diagnosed with VAP in intensive care unit were retrospectively analyzed.They were divided into death group(33 cases)and survival group(74 cases)according to the survival status within 28 d after the first diagnosis of ventilator-associated pneumonia.The disease status and treatment status of the two groups were compared,and multivariate Logistic regression analysis was performed.Results In the death group,the age was(71.67±10.20)years old,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score was(20.79±3.34)points,and the Sequential Organ Failure Assessment(SOFA)score was(7.61±1.82)points,which were higher than(63.61±11.73)years old,(18.19±4.42)points,and(6.03±2.01)points in the survival group;the percentage of parenteral nutrition was 9.09％and the rate of tracheotomy was 36.36％,which were lower than 29.73％and 72.97％in the survival group;there was a statistical difference(P<0.05).There was no statistically significant difference in hormone application,positive end-expiratory pressure ventilation(PEEP)>5 cm H2O(1 cm H2O=0.098 kPa),inappropriate empiric antibiotics,central venous catheter,bacteriological profile and intubation time between the two groups(P>0.05).Multivariate Logistic regression analysis showed that advanced age[95％CI=(1.005,1.129);P=0.033<0.05],high SOFA score[95％CI=(1.375,3.327);P=0.001<0.05]were independent risk factors for death of patients with ventilator-associated pneumonia,tracheotomy[95％CI=(0.029,0.400);P=0.001<0.05],and parenteral nutrition[95％CI=(0.002,0.160);P=0.000<0.05]were the protective factors for death of patients with ventilator-associated pneumonia,and the APACHE Ⅱ score did not have a significant effect on death of patients with ventilator-associated pneumonia(P>0.05).Conclusion Tracheotomy and parenteral nutrition have a positive effect on the prognosis of ventilator-associated pneumonia,then advanced age and high SOFA score increase the mortality rate of patients.
万方数据
维普
