Craven D E, Kunches L M, Kilinsky V, Lichtenberg D A, Make B J, McCabe W R
Am Rev Respir Dis. 1986 May;133(5):792-6.
We studied risk factors for nosocomial pneumonia and fatality in 233 intensive care unit patients requiring continuous mechanical ventilation. Ventilator-associated pneumonia was diagnosed in 49 (21%) of the 233 patients. Of the 8 risk factors univariately associated with the development of pneumonia, only the presence of an intracranial pressure monitor (p less than 0.002), treatment with cimetidine (p less than 0.01), hospitalization during fall-winter seasons (p less than 0.04), and mechanical ventilator circuit changes every 24 h rather than every 48 h (p less than 0.02) remained significant after stepwise logistic regression. The overall fatality rate for the 49 patients who developed ventilator-associated pneumonia was 55%. Ventilator-associated pneumonia was 1 of 18 variables univariately associated with overall patient fatality, but it was not among the 7 variables present after multivariate analysis. The data delineate risk factors associated with the development of nosocomial pneumonia and fatality in patients receiving continuous mechanical ventilation.
我们对233例需要持续机械通气的重症监护病房患者的医院获得性肺炎及死亡风险因素进行了研究。233例患者中，49例（21%）被诊断为呼吸机相关性肺炎。在单因素分析中与肺炎发生相关的8个风险因素中，经过逐步逻辑回归分析后，只有颅内压监测器的使用（p<0.002）、西咪替丁治疗（p<0.01）、秋冬季节住院（p<0.04）以及每24小时而非每48小时更换机械通气回路（p<0.02）仍具有显著意义。49例发生呼吸机相关性肺炎患者的总体死亡率为55%。呼吸机相关性肺炎是单因素分析中与患者总体死亡相关的18个变量之一，但在多因素分析后的7个变量中未出现。这些数据明确了接受持续机械通气患者医院获得性肺炎发生及死亡的相关风险因素。
