1.Risk factors and prognosis of aspiration pneumonia in the elderly
Yuan YUAN ; Ping ZHANG ; Xiaohui DENG ; Rui YUE ; Xiaozhu GE ; Wei WANG ; Wei TIAN
Chinese Journal of Geriatrics 2024;43(3):279-284
Objective:To analyze the disease characteristics of aspiration pneumonia and its risk factors.Methods:In this retrospective case-control study, analysis was conducted on data from 92 patients aged ≥ 60 years admitted to Beijing Jishuitan Hospital, Capital Medical University between June 1, 2018 and July 31, 2022, with aspiration pneumonia(AsP) as the primary diagnosis at the time of hospital discharge and from non-AsP patients admitted during the same period.The number of participants was matched at a 1∶1 ratio.Results:The average age of the AsP group was(80.88 ± 9.41) years and 57(62.0%) were men.The average age of the control group was(77.74 ± 10.98) years and 52(56.5%) were men.There was no statistically significant difference in age and sex ratio(age: t=1.973, P=0.060; sex ratio: χ2=0.661, P=0.416).Univariate analysis showed that, at admission, body mass index(BMI) and activities of daily living(ADL) scores of the AsP group were lower than those of the non-AsP group, the proportions of patients with gastroesophageal reflux disease, acute trauma, cerebrovascular disease, history of cerebral infarction/hemorrhage and sequelae of cerebrovascular disease were higher than those of the non-AsP group(all P<0.05), and the proportions of patients receiving feeding via indwelling nasogastric intubation and tracheal intubation were also higher in the AsP group(all P<0.05).The white blood cell count, the percentage of neutrophils and the procalcitonin level in the first round of tests were higher in the AsP group than those in the non-AsP group and the maximum values of the above parameters during hospitalization were also higher than those in non-AsP patients, while the levels of albumin and prealbumin were lower than those in the non-AsP group( P<0.05 for all).Chest CT showed that 83.7%(77/92) of patients with AsP had bilateral pneumonia, higher than 55.4%(51/92) in the non-AsP group( χ2=8.569, P=0.014).Multivariate Logistic regression analysis showed that male sex( OR=16.206, 95% CI: 1.268-207.191, P=0.032) was a risk factor for AsP, and BMI( OR=0.747, 95% CI: 0.582-0.959, P=0.022) and ADL score at admission( OR=0.945, 95% CI: 0.903-0.988, P=0.014) were protective factors against AsP.ADL score at admission( OR=0.951, 95% CI: 0.907-0.982, P=0.043), tumor history( OR=6.859, 95% CI: 1.484-31.700, P=0.014), history of cerebral infarction/intracerebral hemorrhage( OR=4.368, 95% CI: 1.087-17.511, P=0.038), history of chronic renal insufficiency( OR=5.820, 95% CI: 1.445-23.440, P=0.013), acute respiratory failure( OR=5.281, 95% CI: 1.237-22.545, P=0.013) and myocardial infarction( OR=9.466, 95% CI: 2.151-41.660, P=0.003) were independent factors affecting the prognosis of pneumonia in the elderly. Conclusions:Aspiration pneumonia in the elderly is more common in men and in individuals with low BMI and low ADL scores.There is no increased risk of mortality in people with AsP, compared with people without AsP, but some risk factors in AsP patients may lead to poor prognosis, calling for increased awareness and early intervention in clinical practice.
2.Pathological components of thrombi retrieved with endovascular mechanical thrombectomy in patients with acute ischemic stroke
Mengqian LIU ; Xiaozhu SHEN ; Nan DONG ; Yiwen XU ; Yi JIANG ; Zhonglin GE ; Xiguang LIU ; Guoqing ZHOU ; Qi FANG
International Journal of Cerebrovascular Diseases 2022;30(10):759-765
Endovascular mechanical thrombectomy (EMT) has become the main treatment of acute ischemic stroke, but the pathological study of thrombi retrieved with EMT is still very limited. This article reviews the routine staining, special components, expression of immune factors, electron microscopic morphology, imaging features of the pathological components of thrombi retrieved with EMT, and their correlation with the etiological differentiation and outcomes of stroke.
3. Analysis of clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture
Yuan YUAN ; Wei TIAN ; Xiaohui DENG ; Rui YUE ; Xiaozhu GE ; Xinbao WU ; Ping ZHANG
Chinese Journal of Geriatrics 2019;38(12):1377-1382
Objective:
To investigate the clinical characteristics and risk factors for pulmonary infection in elderly patients with hip fracture after the treatment through a model of orthopedic-geriatric co-care, in order to provide prevention and control strategies.
Methods:
Clinical data and laboratory results of elderly patients with hip fractures admitted into our hospital from January 2016 to May 2016 were collected.The differences in treatment outcome and adverse reactions were retrospectively compared between the two groups of patients with versus without pulmonary infection, and univariate and multivariate analysis of lung infection were performed.
Results:
Of 207 patients, 43 were infected with pneumonia and 164 were not.The proportion of patients with the time interval<48 h from admission to surgery was 48.6%(86/177), and the time interval<1 week from admission to surgery was 98.9%(175/177). The average length of hospital stay was(7.9±3.5)days.There was no significant difference in the time interval from admission to surgery, the time spent on surgery, length of hospital stay, surgical procedure and inflammatory indicators between the pneumonia and non-pneumonia groups.Univariate analysis showed that advanced age, multiple primary diseases, primary lung diseases, chronic respiratory failure, cerebrovascular disease, sequelae of cerebrovascular disease, immune system disease or long-term oral hormone therapy and preoperative anemia were risk factors for pulmonary infection in elderly patients with hip fracture(