Study on Risk Factors of Ventilator-Associated Pneumonia in Elderly Patients with Acute Cerebral Infarction Treated with Endotracheal Intubation and Mechanical Ventilation

Abstract

To investigate the risk factors of ventilator-associated pneumonia in elderly patients with acute cerebral infarction and to provide guidance for clinical prevention and treatment is the main objective. Gramnegative bacteria 38 strains (67.86 %), Gram-positive bacteria 15 strains (26.79 %) and fungi 3 strains (5.36 %) were detected by pathogenic bacteria culture. There was no significant difference in age, gender, body mass index, smoking, drinking, hypertension, diabetes and coronary heart disease between ventilator-associated pneumonia group and non-ventilator-associated pneumonia group (p>0.05); there were significant differences between ventilator-associated pneumonia group and non-ventilator-associated pneumonia group in antibiotic prophylactic use, time of ventilator use, acute physiology and chronic health evaluation II score and serum albumin level (p<0.05). The receiver operating characteristic curve was drawn and the results showed that the sensitivity of acute physiology and chronic health evaluation II score in predicting ventilator-associated pneumonia in patients with acute cerebral infarction was 93.71 %, the specificity was 77.61 % and the area under the curve value was 0.894. The sensitivity and specificity of albumin in predicting ventilator-associated pneumonia in elderly patients with acute cerebral infarction were 78.51 %, 76.92 % and 0.857 respectively. Multivariate logistic analysis showed that prophylactic use of antibiotics and high serum albumin level could effectively reduce the risk of ventilator-associated pneumonia in elderly patients with acute cerebral infarction undergoing endotracheal intubation and mechanical ventilation (p<0.05), while prolonged time of ventilator use and increased acute physiology and chronic health evaluation II score would increase the risk of ventilator-associated pneumonia in elderly patients with undergoing endotracheal intubation and mechanical ventilation (p<0.05). There are many factors influencing the occurrence of ventilator-associated pneumonia in the elderly patients with acute cerebral infarction undergoing endotracheal intubation and mechanical ventilation, and the intervention according to the risk factors has a positive preventive effect.