To investigate the risk factors of nosocomial pneumonia (NP) in elderly patients with acute cerebral infarction (ACI).In this study, 324 aged 70 years and over patients with ACI who were admitted to the inpatient department of TianJin First Hospital (China) from January 2012 to February 2018 were retrospectively analyzed. The patients were divided into NP group (80 patients) and non-NP group (244 patients) according to whether NP was occurred 48 hours after hospitalization. Baseline profiles and biochemical analyses were compared between 2 groups. Information regarding risk factors for NP in elderly patients with ACI was collected from all patients. Associations with NP and outcome were evaluated.Among the total patients, NP occurred in 80 (24.69%) patients. There were no statistically significant differences between risk of NP and sex, current drinking, diabetes mellitus, stroke history, and levels of serum UA, TG, HDL-C, LDL-C, Glucose, chloride, potassium. Multivariate logistic regression analysis showed that the independent risk factors for NP were living alone (OR 4.723; CI 1.743∼12.802; P = .002), initial NIHSS score (OR 1.441; CI 1.191∼1.743; P = .000), NRS2002 score (OR 0.139; CI 0.087∼0.223; P = .000), BMI (OR 1.586; CI 1.353∼1.858; P = .000), a past pneumonia history (OR 0.073; CI 0.017∼0.321; P = .001), atrial fibrillation (AF) (OR 0.129; CI 0.033∼0.499; P = .003), CRP (OR 1.050; CI 1.017∼1.085; P = .003), BUN (OR 0.603; CI 0.448∼0.812; P = .001) and Cr (OR 1.036; CI 1.015∼1.057; P = .001). Level of albumin was an independent protective factor of NP in elderly patients with ACI (OR 0.865; CI 0.750∼0.999; P = .048). Furthermore, elderly patients with ACI who had NP had worse clinical outcomes both during hospitalization and after discharge (P < .05).We identified significant risk factors for NP in elderly patients with ACI, including living alone, initial NIHSS score, malnutrition, a past pneumonia history, AF, CRP, and Renal function were associated with NP in elderly patients with ACI. The clinical course was worse and the duration of hospital stay was longer in NP patients than in non-NP patients.
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机译：目的探讨老年急性脑梗死（ACI）患者医院内肺炎（NP）的危险因素。本研究从中国天津市第一医院住院部收治的324名70岁以上的ACI患者对2012年1月至2018年2月进行回顾性分析。根据住院后48小时是否发生NP分为NP组（80例）和非NP组（244例）。比较两组的基线概况和生化分析。从所有患者中收集有关老年ACI患者NP危险因素的信息。评估NP与结局的相关性。在所有患者中，NP发生在80名患者中（24.69％）。 NP和性别，当前饮酒，糖尿病，中风史以及血清UA，TG，HDL-C，LDL-C，葡萄糖，氯化物，钾的水平之间无统计学差异。多元logistic回归分析显示，NP的独立危险因素是独自生活（OR 4.723; CI 1.743〜12.802; P = .002），初始NIHSS评分（OR 1.441; CI 1.191〜1.743; P = .000），NRS2002评分（OR 0.139; CI 0.087〜0.223; P = .000），BMI（OR 1.586; CI 1.353〜1.858; P = .000），既往有肺炎病史（OR 0.073; CI 0.017〜0.321; P = .001），心房颤动（AF）（OR 0.129; CI 0.033〜0.499; P = .003），CRP（OR 1.050; CI 1.017〜1.085; P = .003），BUN（OR 0.603; CI 0.448〜0.812; P = 0.001 ）和Cr（OR 1.036; CI 1.015-1.057; P = .001）。白蛋白水平是老年ACI患者NP的独立保护因子（OR 0.865； CI 0.750〜0.999； P = .048）。此外，患有NP的老年ACI患者在住院期间和出院后的临床结局均较差（ P <.05）。我们确定了老年ACI老年患者NP的重要危险因素，包括独自生活，最初的NIHSS评分，营养不良，既往肺炎史，AF，CRP和肾功能与ACI老年患者的NP相关。与非NP患者相比，NP患者的临床病情恶化，住院时间更长。
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