Hospitalization of Nursing Home Patients in Chicago, U. S. A.

美國芝加哥區養老院病人急症住院之原因及其危險因子

許清曉(Clement C.S. Hsu) ； 許玉麗(Yu-Li Hsu) ； David Edelberg ； M. Todd Grendon

《中華民國公共衛生學會雜誌》 10卷1期 (1990/03) Pp. 30-38

https://doi.org/10.6288/JNPHARC1990-10-01-04

摘要

吾等在美國芝加哥之一社區教學醫院做前瞻性的臨床研究，調查養老院病人急症住院診治之原因及其危險因子。受調查之住院個案包括243位病人之326次住院。感染為住院之最常見原因(51.2%)。而皮膚及鄰近組織感染(17.5%)，肺淡(13.8%)，尿道感染(12.6%)及敗血症(6.7%)為其主要類別。感染為總共59.5%住院病人之入院主因或次要診斷。
以132人次無感染症之養老院病人住院為控制組，吾等以Stepwise logistic regression analysis評估每一類別感染症之獨立危險因子。體內異物之存在，尤其是留置導尿管，為每一感染類別之危險因子。不動性亦為和肺炎除外之三額感染症相關的因子。此外，糖尿病和皮膚及鄰近組織感染有關聯；而高年齡則和肺炎之發生有關。這些因子之致病機轉需更進一步之探討，以便給予比類病人適當的醫護。

並列摘要

A ten month prospective clinical survey was conducted at a teaching community hospital on 326 admissions of 243 patients from 32 nursing homes in the Chicago area. Infection was found to be the most frequent cause of admission (51.2%). Skin and adjacent tissue infection (17.5%), pneumonia (13.8%), urinary tract infection (12.6%), and septicemia (6.7%) were the major categories of infection. A total of 59.5% of the patients had infection as a primary and/or secondary diagnosis.
Using 132 nursing home patients without either primary or secondary diagnosis of infection as the control group, independent risk factors of devlopment of all types of infection were assessed by employing a stepwise logistic regression analysis. The presence of foreign body, especially the indwelling urinary catheter, was the risk factor for every category of infection. Immobility was also a variable associated with all infections, except pneumonia. In addition, diabetes mellitus was a risk factor for skin and adjacent tissue infection, and advanced age for pneumonia. Mechanisms underlying these risk factors need further research.

並列關鍵字

Nursing home ； Hospitalization ； Risk Factors for Hospitalization ； Immobility ； Foreign Bodies