The Prognostic Factors of Bloodstream Infection in Immunosuppressed Elderly Patients: A Retrospective, Single-center, Five-year Cohort Study.
The Prognostic Factors of Bloodstream Infection in Immunosuppressed Elderly Patients: A Retrospective, Single-center, Five-year Cohort Study.
复制标题
免疫抑制老年患者血流感染的预后因素：一项回顾性、单中心、五年队列研究
DOI：
10.2147/cia.s386922
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
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老年患者免疫抑制状态可能增加死亡风险。目前，很少有研究探讨老年免疫抑制人群伴血流感染的临床特点。我们的目的是评估免疫抑制的老年血流感染患者的预后因素。方法选取2015年至2019年在我院就诊时诊断为免疫抑制状态血流感染的老年患者376例。分析90天生存组和90天死亡组患者的人口学资料、基础疾病、合并症、诱因、并发症、病原体来源、病因及抗生素治疗情况。采用单因素logistic回归分析和多因素logistic回归分析评价影响90天死亡率的预后因素。结果分析了376例诊断为血液感染的免疫抑制老年人的临床特点，其中90天死亡率111例。通过单因素logistic回归分析和多因素logistic回归分析，我们发现ICU住院（OR: 2.052, 95%CI: 1.088 ~ 3.871, p=0.026）、BMI下降（OR: 0.307, 95%CI: 0.130 ~ 0.723, p=0.007）、冠心病（OR: 2.028, 95%CI: 1.078 ~ 3.816, p=0.028）、胆道感染（OR: 4.406, 95%CI: 1.794 ~ 10.821, p=0.001）和替加环素使用（OR: 2.480, 95%CI: 1.195 ~ 5.147, p=0.015）在90天生存组和90天死亡组之间存在显著差异。结论入住ICU、冠心病、胆道感染、使用替加环素是免疫抑制老年人90天死亡率的独立预后危险因素，BMI下降是保护因素，有助于区分免疫抑制老年人血液感染的预后因素。
Introduction Elderly patients with immunosuppressive status may have increased risk of mortality. At present, few studies have explored the clinical characteristics of the elderly immunosuppressed population with bloodstream infection. Our objectives were to evaluate the prognostic factors in immunosuppressed elderly patients with bloodstream infection. Methods Three hundred and seventy-six elderly patients who were diagnosed with bloodstream infection in immunosuppressive status while receiving treatment in our hospital were selected from 2015 to 2019. The demographic data, underlying diseases, comorbidity, inducement, complications, pathogen sources, etiologies and the antibiotic therapy were analyzed between 90-day survival groups and 90-day mortality groups. The prognostic factors of 90-day mortality were evaluated by univariate logistic regression analysis and multivariate logistic regression analysis. Results The clinical characteristics of 376 immunosuppressed elderly people diagnosed with bloodstream infection were analyzed, and among those people about 111 were 90-day mortality. By univariate logistic regression analysis and multivariate logistic regression analysis, we found ICU admission (OR: 2.052, 95%CI: 1.088–3.871, p=0.026), the decrease in BMI (OR: 0.307, 95%CI: 0.130–0.723, p=0.007), coronary heart disease (OR: 2.028, 95%CI: 1.078–3.816, p=0.028), biliary infection (OR: 4.406, 95%CI: 1.794–10.821, p=0.001) and the use of tigecycline (OR: 2.480, 95%CI: 1.195–5.147, p=0.015) were significantly different between the 90-day survival and 90-day mortality groups. Conclusion ICU admission, coronary heart disease, biliary infection, and the use of tigecycline were the independent prognostic risk factors of 90-day mortality in immunosuppressed elderly people, and the decrease in BMI was the protective factor, which would have the benefit of discriminating the prognostic factors in immunosuppressed elderly people with bloodstream infection.