Chen Zhen, Song Tianshuang, Li Yilan, Luo Ling, Li Ziqiong, Zhao Qinghua
Department of Infection, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China.
Nursing Department, The First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China.
Am J Transl Res. 2021 Oct 15;13(10):11014-11025. eCollection 2021.
This study aimed to review the pulmonary infection risk factors in long-term bedridden patients. The Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, Wanfang, and the China Biomedical Literature Service System databases were searched to retrieve articles on the clinical risk factors, from database establishment to July 31, 2020. Two researchers independently screened the search results, evaluated the quality of the studies using NOS criteria, and extracted the data. The meta-analysis was performed using RevMan 5.3. A total of 13 articles including 10,182 patients were included. The statistically significant risk factors included age (OR=1.82), diabetes (OR=2.15), hormones (OR=3.14), consciousness disorders (OR=3.83), BMI<18.5 kg/m (OR=1.57), antibiotics (OR=2.21), smoking history (OR=1.68), nasal-feeding (OR=4.64), ventilator use (OR=5.95), invasive operations (OR=5.04), hospitalization times (OR=3.16), and stay-in-bed times (OR=2.69). Therefore, according to the OR values, age, a BMI<18.5 kg/m, and smoking history were low risk-factors (2≥OR>1). Diabetes, antibiotics, and stay-in-bed times were medium risk-factors (3≥OR>2). Hormone levels, consciousness disorders, nasal-feeding, ventilator use, invasive operations, and hospitalization times were high risk-factors (OR>3). In conclusion, the low risk-factors (age, BMI, smoking history), the medium risk-factors (diabetes, antibiotics, stay-in-bed length), and especially the high risk-factors (hormones, consciousness disorders, nasal-feeding, ventilator use, invasive operations, hospitalization times) deserve more attention for preventing pulmonary infections in long-term bedridden patients.
本研究旨在回顾长期卧床患者肺部感染的危险因素。检索Cochrane图书馆、PubMed、EMBASE、Web of Science、中国知网、万方和中国生物医学文献服务系统数据库,以获取从数据库建立至2020年7月31日有关临床危险因素的文章。两名研究人员独立筛选检索结果,使用NOS标准评估研究质量,并提取数据。使用RevMan 5.3进行荟萃分析。共纳入13篇文章,涉及10182例患者。具有统计学意义的危险因素包括年龄(OR=1.82)、糖尿病(OR=2.15)、激素(OR=3.14)、意识障碍(OR=3.83)、BMI<18.5 kg/m(OR=1.57)、抗生素(OR=2.21)、吸烟史(OR=1.68)、鼻饲(OR=4.64)、使用呼吸机(OR=5.95)、侵入性操作(OR=5.04)、住院时间(OR=3.16)和卧床时间(OR=2.69)。因此,根据OR值,年龄、BMI<18.5 kg/m和吸烟史为低危险因素(2≥OR>1)。糖尿病、抗生素和卧床时间为中度危险因素(3≥OR>2)。激素水平、意识障碍、鼻饲、使用呼吸机、侵入性操作和住院时间为高危险因素(OR>3)。总之,低危险因素(年龄、BMI、吸烟史)、中度危险因素(糖尿病、抗生素、卧床时长),尤其是高危险因素(激素、意识障碍、鼻饲、使用呼吸机、侵入性操作、住院时间)在预防长期卧床患者肺部感染方面值得更多关注。