Study On Risk Factors Of Multiple Organ Dysfunction Syndrome In Elderly Patients With Respiratory Failure

Objective This research mainly investigates the occurrence and incidence of secondary multiple organ dysfunction syndrome(MODS)in elderly patients with respiratory failure.Through logistic regression analysis model,the influencing factors of secondary multiple organ dysfunction in elderly patients with respiratory failure are analyzed in depth,and the related risk factors are explored,which is conducive to formulating prevention and control strategies for clinical intervention.Furthermore,it will reduce the incidence of multiple organ dysfunction syndrome and provide a background for the research in this direction.Method This study was carried out by using a cross-sectional designing method.By reviewing the clinical data of 208cases of elderly respiratory failure admitted to our hospital from February 2016 to October 2018,according to whether the secondary to the grouping of multiple organ dysfunction syndrome,recorded in detail the general data and laboratory indexes,by EpiData 3.1 on the original data entry,SPSS 25.0 to analyze data,categorical data including gender,presence of CO2 retention,presence of pulmonary fibrosis,the types of the primary disease,whether smoking index of more than heavy index,hypertension,diabetes,hyperlipidemia,chronic hepatitis,malnutrition,immune function is low,invasive mechanical ventilation,growth season,metabolic acidosis,respiratory acidosis,application of diuretics use frequency,percentage was described;Measurement data including age,BMI and APACHEII score were described with standard deviation after normality test.Chi-square test was used for univariate analysis.Logistic regression analysis model was used to determine the risk factors of multiple organ dysfunction secondary to respiratory failure in the elderly.P<0.05 was considered statistically significant.Result Among 208 patients with respiratory failure,34 patients had secondary multiple organ dysfunction syndrome,and the incidence was 16.35%(34/208),including six cases of cardiovascular function failure and liver failure,four cases of cardiovascular function failure and renal failure,eleven cases of liver failure and renal failure,four cases of liver failure and renal failure and gastrointestinal function failure,four cases of liver failure and brain function failure,two case of brain function failure and blood coagulation system obstacles,two case of liver failure and pancreatic function failure,one case of the central nervous system function failure and brain function failure,The constituent ratios are as follows:17.65%(6/34),11.76%(4/34),32.35%(11/34),11.76%(4/34),11.76%(4/34),5.88%(2/34),5.88%(2/34),2.94%(1/34).The results of single-factor analysis showed that there was no statistical difference in gender,primary disease type distribution,BMI>25kg/m~2,hyperlipidemia,and severe climate change between the two groups(P>0.05).Patients in the occurrence group with age>80 years,and carbon dioxide retention,pulmonary fibrosis,smoking index>400/year,hypertension,diabetes mellitus,chronic hepatitis merge,malnutrition,low immune function,invasive mechanical ventilation,APACHEII>15 points,metabolic acidosis,respiratory acidosis composition ratio are higher than the patients in the absence group(P<0.05),and the incidence rate of diuretic users is lower than the absence group(P<0.05).Logistic regression analysis showed that age>80 years,carbon dioxide retention,pulmonary interstitial fibrosis,smoking index>400 cigarettes per year,hypertension,diabetes mellitus,chronic hepatitis,malnutrition,low immune function,invasive mechanical ventilation,APACHEII>15,metabolic acidosis,respiratory acidosis were all the independent risk factors of multiple organ dysfunction syndrome secondary to respiratory failure in the elderly.While the diuretic application is a protection factor.OR values are 3.291,14.455,5.702,11.250,5.030,5.100,4.559,3.660,7.168,2.953,7.168,4.545,3.352 and 0.087,respectively.Conclusion There are many risk factors of respiratory failure secondary to multiple organ dysfunction syndrome in elderly patients.,Factors including age>80 years,carbon dioxide retention,pulmonary fibrosis,smoking index>400/year,hypertension,diabetes mellitus,chronic hepatitis merge,malnutrition,low immune function,invasive mechanical ventilation,APACHEII>15 points,metabolic acidosis,respiratory acidosis can increase the risk.Diuretic application can reduce the risk of multiple organ dysfunction syndrome.By combining with the research and analysis of the related factors,the prevention strategies to strengthen the prevention and controlling of multiple organ dysfunction syndrome can be well provided for clinical,and further reduce the incidence and the mortality rate of multiple organ dysfunction syndrome secondary to respiratory failure in the elderly.