The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Wenzhou Central Hospital, Wenzhou, China.
Clin Nurs Res. 2022 Nov;31(8):1454-1461. doi: 10.1177/10547738221114713. Epub 2022 Sep 8.
This study aimed to conduct a longitudinal study to explore the influencing factors of pulmonary infection in elderly patients with hip fracture after surgery, to provide evidence and reference for the early identification and nursing care of patients at high risk of postoperative pulmonary infection.A secondary analysis was conducted of electronic medical record data from elderly patients with hip fractures treated in a tertiary hospital from January 1, 2020 to June 30, 2021.A total of 526 patients were included. Age ≥70 years (odd ratio [] 2.042, 95% confidence interval [CI] [1.516-4.022]), history of smoking ( 2.755, 95% CI [2.009-3.175]), time from fracture to operation ≥5 days ( 3.117, 95% CI [1.925-3.911]), American Society of Anesthesiologists grade ≥II ( 1.254, 95% CI [1.053-1.921]), chronic obstructive pulmonary disease ( 2.832, 95% CI [1.775-3.808]), hypoproteinemia ( 1.395, 95% CI [1.022-1.841]), red blood cell distribution width >15% ( 3.142, 95% CI [2.104-4.172]), intensive care unit stay ( 2.174, 95% CI [1.083-3.718]) and duration of mechanical ventilation ≥180 minutes ( 3.117, 95% CI [2.199-4.807]) were the independent risk factors (all < .05).Early nursing care should be taken for patients with risk factors to reduce the pulmonary infection.
本研究旨在进行一项纵向研究，以探索老年髋部骨折患者术后肺部感染的影响因素，为术后肺部感染高危患者的早期识别和护理提供依据和参考。对 2020 年 1 月 1 日至 2021 年 6 月 30 日在一家三级医院治疗的老年髋部骨折患者的电子病历数据进行了二次分析。共纳入 526 例患者。年龄≥70 岁（比值比[]2.042，95%置信区间[CI] [1.516-4.022]）、吸烟史（ 2.755，95% CI [2.009-3.175]）、骨折至手术时间≥5 天（ 3.117，95% CI [1.925-3.911]）、美国麻醉医师协会分级≥II 级（ 1.254，95% CI [1.053-1.921]）、慢性阻塞性肺疾病（ 2.832，95% CI [1.775-3.808]）、低蛋白血症（ 1.395，95% CI [1.022-1.841]）、红细胞分布宽度>15%（ 3.142，95% CI [2.104-4.172]）、入住重症监护病房（ 2.174，95% CI [1.083-3.718]）和机械通气时间≥180 分钟（ 3.117，95% CI [2.199-4.807]）是独立的危险因素（均<0.05）。对于有危险因素的患者，应采取早期护理，以减少肺部感染。
