Etiology Of Hospital Acquired Pneumonia In The Elderly And Risk Factors For Prognosis

Objectives To investigate the etiologic distribution,and impact factors for prognosis of the hospital-acquired pneumonia in the elderly patients. Aimed at prognostic factors,reference of applying associated interventions in the clinical practice in order to improve the therapeutic approach to HAP in the elder and potential people reduce mortality.Methods By using the way of historical study, Clinical data of the elderly patients form all departments admitted to the Affiliated Hospital of North China University of science and technology from between 2014-October 2015 were retrospectively analyzed, and filled in the self-made questionnaire in detail. All the enrolled patients were Most of the18 years old and over. Elderly patients were 65 years old and over. Collect the general clinical data, basic diseases, relevant laboratory examination results, clinical manifestation, etiology cultivation, whether indwelling catheter, whether mechanical ventilation, acute physiology and chronic health evaluation(APACHE II score),treatment of patients with a terminal condition ect. Through single factor and multiple factors logistic review analysis methods affect the prognosis of elderly patients with hospital acquired pneumonia multiple risk factors.Results 1 The mean age of elderly patients was 78.20±7.48 years. In the elderly group,the average periods of treatment was 31.8±20.5 days, APACHEII score 17±10. The disease of heart and bead diseases, liver damage, pleural effusion, aspiration,double pneumonia, pleural effusion, indwelling catheter occurring in the body more than the other(P < 0.05). 2 Elderly patients are mainly distributed in Neurology,Geriatrics,ICU,etc.The constituent ratio is 27.97%, 20.34%, 14.41%, etc. 3 In June2014 to October 2015, the most common pathogenic Gram-negative bacteria of HAP in the elderly in our hospital were: Baumannii, Klebsiella pneumoniae, Pseudomonas aeruginos, escherichia coli; gram-positive bacteria were: staphylococcus aureus,staphylococcus pneumoniae, staphylococcus saprophyticus; Fungus were : Candida albicans. 4 Univariate analysis showed that the prognostic factors of HAP are: The stroke, tumour, diabetes, The history of aspiration, Indwelling catheter in the body,APACHE??10. 5 Acinetobacter baumannii, staphylococcus aureus and mixed bacteria infection in patients with clinical prognosis is poor.Conclusions:1 our hospital in elderly patients with hospital acquired pneumonia is the most common gram-negative bacterium for acinetobacter baumannii, with klebsiella pneumoniae, pseudomonas aeruginosa and so on, the most common gram-positive bacterium for golden glucose coccus and streptococcus pneumoniae. 2 Suffering from cerebrovascular disease, tumor, diabetes, aspiration, indwelling catheter in the body and APACHE ? score 10 or more into the dangerous factors of prognosis of elderly patients with hospital acquired pneumonia. 3 Acinetobacter baumannii infection, golden glucose coccus and mixed bacteria in the elderly patients with clinical prognosis is poor.