[Investigation of the risk factors and prevention of nosocomial tracheobronchitis in elderly patients on mechanical ventilation in surgical intensive care unit].
OBJECTIVE
To investigate the incidence, the risk factors and the outcome of nosocomial tracheobronchitis (NTB) in patients age over 65 years of age receiving mechanical ventilation (MV).


METHODS
Using prospective cohort study to collect and analyse the clinical information of elderly patients who received mechanical ventilation in surgical intensive care unit (ICU) of Zhongshan Hospital, from November 2002 to July 2004. Patients with first episodes of NTB were compared with those without NTB by univariate analysis and logistic regression.


RESULTS
There were 35 elderly patients diagnosed as having NTB (53.0%). The differences in serum albumin, nasal feeding, the length of ICU stay, the duration of MV days, the acute physiology and chronic health evaluation II (APACHE II) score and the kinds of the antibiotic used between patients with NTB and without NTB were significant. The results of the univariate analysis showed that nasal feeding, low serum albumin, the duration of the MV>4 days, the length of ICU stay >9 days, the kinds of antibiotics used and the APACHE II score higher than 9 were the risk factors of NTB. However the logistic regression suggested that nasal feeding, MV days >4 days, nasal feeding and the kinds of the antibiotics used >2 are the independent risk factors of NTB.


CONCLUSIONS
There is high incidence of NTB in ventilated patients in surgical ICU. Low albumin level, nasal feeding, prolonged MV and ICU stay days, high APACH II score and administration of too much antibiotics are the important risk factors of NTB.
Liu
Qing-hua
QH
Zhongshan Hospital, Fudan University, Shanghai 200032, China.
He
Li-xian
LX
Zhu
Du-ming
DM
Hu
Bi-jie
BJ
Li
Hua-yin
HY
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001991:Bronchitis / Q000453:epidemiology / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012307:Risk Factors; D014136:Tracheitis / Q000453:epidemiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents