Risk factors for pulmonary infection in severe neurological patients

Abstract

Objective To analyze the influencing factors for pulmonary infection in neurosurgical critical patients, and provide references for prevention and treatment of pulmonary infection. Methods Sixty-five patients with severe neurological diseases complicated with pulmonary infection, admitted to our hospital from May 2017 to May 2018, were chosen in our study. General information, laboratory examination results, chest CT and other imaging results, hospital stay, antibiotic/ventilator use, tracheotomy and other treatments of these patients were collected and compared to identify the independent factors influencing pulmonary infection in patients with severe neurological disease. Results There was a statistically significant difference in incidence of pulmonary infection among patients with different diseases (P<0.05), and the infection rate of patients with cerebral hemorrhage was the highest, reaching to 50.8% (32/63). GCS scores (OR=2.903, 95%CI: 1.069-7.881, P=0.037), serum albumin level (OR=3.690, 95%CI: 1.157-11.768, P=0.027), ventilator use (OR=15.799, 95%CI: 6.305-39.591, P=0.000), tracheotomy or endotracheal intubation (OR=7.036, 95%CI: 2.913-16.993, P=0.000), history of diabetes (OR=2.442, 95%CI: 1.026-5.809, P=0.043), and prophylactic use of antibiotics (OR=6.021, 95CI%: 2.340-15.489, P=0.000) were independent risk factors for pulmonary infection in patients with severe neurological conditions. Conclusion Effective measurements, including recovering consciousness as soon as possible, shortening accommodation, actively avoiding endotracheal intubation and ventilator-associated pneumonia, and rectifying hypoproteinemia and diabetes mellitus can effectively prevent the occurrence of severe pulmonary infection of neurosurgical critical patients. Key words: Severe nervous system; Pulmonary infection; Influencing factor