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 evaluationⅡ (APACHEⅡ) 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 MV4 days, the length of ICU stay 9 days, the kinds of antibiotics used and the APACHEⅡ score higher than 9 were the risk factors of NTB. However the logistic reggression 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. Conclusion There is high incidence of NTB in ventilated patients in surgical ICU. Low albumin level, nasal feeding, prolonged MV and ICU stay days, high APACHⅡ score and administration of too much antibiotics are the important risk factors of NTB.