Department of Infection, Nantong First People's Hospital, No. 6, Haier Lane North Road, Nantong, Jiangsu 226000, China.
Department of Rehabilitation, Nantong First People's Hospital, No. 6, Haier Lane North Road, Nantong, Jiangsu 226000, China.
Dis Markers. 2022 Apr 29;2022:7711724. doi: 10.1155/2022/7711724. eCollection 2022.
Pulmonary infection in the emergency ICUs increases patient morbidity, hospital stay, treatment costs, and the risk of related adverse events.
This study included 695 patients admitted to our emergency ICU between December 2019 and March 2021. Medical records of emergency ICU patients were reviewed to collect their clinical data, including antibiotic use, history of tracheostomy, history of mechanical ventilation, presence or absence of underlying disease, history of smoking, alcohol consumption, age, gender, and history of shock. Bacterial cultures were performed. The incidence, main clinical features, main pathogens, and risk factors of pulmonary infection in emergency ICU were analyzed.
In this study, 69 of the 695 emergency ICU patients (9.93%) developed pulmonary infection. The main clinical features of patients with pulmonary infection included cough and expectoration (97.10%), shortness of breath and chest tightness (95.65%), leukocyte elevation (69.57%), confusion (31.88%), drowsiness (28.99%), persistent fever (27.54%), and nausea and vomiting (10.14%). The main pathogenic bacteria in those with pulmonary infection included (62.32%), (49.28%), (21.74%), (39.13%), (7.25%), (15.95%), (24.64%), and lung diplococcus inflammatory (13.04%). Univariate analysis showed that there were no significant differences in the occurrence of pulmonary infection with regard to sex, smoking, and alcohol consumption, but there were significant differences with regard to age, basic disease, invasive surgery, and shock. Logistic regression analysis confirmed that age ≥ 80 years, invasive surgery, shock, and basic diseases ≥ 2 were important risk factors for pulmonary infection in emergency ICU patients.
Considering the clinical features and risk factors for pulmonary infection in the emergency ICU, preventive and control measures are required to minimize its occurrence and ensure good outcomes.
急诊 ICU 中的肺部感染会增加患者的发病率、住院时间、治疗费用和相关不良事件的风险。
本研究纳入了 2019 年 12 月至 2021 年 3 月期间入住我院急诊 ICU 的 695 名患者。回顾性分析急诊 ICU 患者的病历资料,收集其临床资料,包括抗生素使用情况、气管切开史、机械通气史、是否存在基础疾病、吸烟史、饮酒史、年龄、性别、休克史。进行细菌培养。分析急诊 ICU 肺部感染的发生率、主要临床特征、主要病原体及危险因素。
本研究中,695 例急诊 ICU 患者中 69 例(9.93%)发生肺部感染。肺部感染患者的主要临床特征包括咳嗽咳痰(97.10%)、呼吸急促和胸闷(95.65%)、白细胞升高(69.57%)、意识模糊(31.88%)、嗜睡(28.99%)、持续发热(27.54%)和恶心呕吐(10.14%)。肺部感染的主要病原菌包括铜绿假单胞菌(62.32%)、肺炎克雷伯菌(49.28%)、大肠埃希菌(21.74%)、鲍曼不动杆菌(39.13%)、金黄色葡萄球菌(7.25%)、肺炎链球菌(15.95%)、流感嗜血杆菌(24.64%)和肺炎双球菌(13.04%)。单因素分析显示,性别、吸烟、饮酒与肺部感染的发生无显著差异,而年龄、基础疾病、有创性手术、休克则有显著差异。Logistic 回归分析证实,年龄≥80 岁、有创性手术、休克和基础疾病≥2 项是急诊 ICU 患者肺部感染的重要危险因素。
考虑到急诊 ICU 肺部感染的临床特征和危险因素,需要采取预防和控制措施,以尽量减少其发生并确保良好的预后。