肺炎住院病人特性及住院天數之影響因子

Characteristics and factors influencing length of stay in hospitalized patients with pneumonia

10.6288/TJPH.202012_39(6).109101

沈季香(Chi-Hsiang Shen)；楊麗玉(Li-Yu Yang)

肺炎 ； 住院天數 ； 住院病人 ； pneumonia ； length of stay ； inpatient

台灣公共衛生雜誌

39卷6期（2020 / 12 / 15）

686 - 695

繁體中文

目標：隨著人口高齡化，肺炎的發生率有逐年攀升趨勢，不僅是國人健康的一大威脅，隨著住院天數的延長，更會增加健康醫療服務的經濟負擔。本研究目的係探討肺炎住院病人特性及住院天數的影響因子。方法：採回溯性相關性研究，從病歷的次級資料進行分析，研究對象為2013年至2017年台灣南部某醫學中心之內科住院病人，以羅吉斯迴歸分析檢定病人特性與住院天數之相關性及影響程度。結果：本研究收集初診斷肺炎住院之病人共488人，平均年齡72.3（±17.9）歲，平均住院天數為17.6天。研究發現鼻胃管留置（p ＜ 0.001）、共存疾病數（p =0.031）與住院天數達顯著性相關。進一步以羅吉斯迴歸分析影響住院天數長短的因素發現，有鼻胃管留置者（β= 1.525, p ＜ 0.001）、執行胸腔物理治療者（β= 0.622, p = 0.002），其住院超過12天的風險越高，其中以鼻胃管留置的相關性最高。結論：影響肺炎住院天數的因素主要為鼻胃管留置，故建議醫療照護人員應適時評估個案鼻胃管留置的必要性，以期能降低住院天數，提供未來醫療機構改善肺炎住院天數之參考。

Objectives: With population aging, the incidence of pneumonia is increasing yearly, representing a major threat to people's health in Taiwan as well as contributing to increasing lengths of hospitalization and the economic burden of health care. The purpose of this study was to investigate the influence of the characteristics of patients with pneumonia on their length of hospital stay. Methods: A retrospective correlation study was conducted. Data were collected from 2013 to 2017 in the medical ward of a medical center located in southern Taiwan. Logistic regression analysis was performed. Results: A total of 488 patients with pneumonia were recruited and enrolled as participants. The mean age of the participants was 72.3 (±17.9) years, and the mean length of stay was 17.6 days. The results demonstrated that the use of nasogastric tubes (p ＜ .001) and comorbidities (p = .031) were both significantly correlated with length of stay. Logistic regression analysis indicated that the use of a nasogastric tube (β = 1.525, p ＜.001) and chest physical therapy (β = 0.622, p = .002) increased the risk of the length of stay extending to more than 12 days, with nasogastric tubes exhibiting the highest correlation. Conclusions: The use of nasogastric tubes affects the length of hospital stay of pneumonia inpatients. We therefore suggest that clinical nurses assess the necessity of nasogastric tube indwelling, as selective deployment may reduce the length of hospital stay of patients with pneumonia. This study can serve as a reference for clinicians seeking to reduce the length of stay of patients with pneumonia.

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