2023年甘肃省93家医院呼吸机相关肺炎监测报告

Surveillallce report of prevalence of ventilator-associated pneumonia in 93 hospitals of Gansu Province in 2023

  • 摘要:
    目的 本研究旨在回顾性分析甘肃省2023年呼吸机相关肺炎(VAP)的发生情况, 为该省医疗机构制定和优化VAP防控策略提供科学依据。
    方法 通过对甘肃省医院感染管理质控中心区域监测平台2023年VAP相关数据的分析, 采用Poisson回归模型评估VAP发生的影响因素。
    结果 在2023年, 甘肃省93家医院的VAP发病率中位数为3.51‰。甘肃省不同地区、医院等级和类型的VAP发病率差异存在统计学意义(P<0.05)。三级医院的住院天数3 458(1 904 6 770) d、呼吸机使用天数1 274(740 2 040) d和VAP发病率4.89(2.82, 7.40) ‰均高于二级医院(均P<0.05);综合医院的VAP发病率3.94(2.66, 6.92) ‰高于专科医院2.06(1.03, 3.27) ‰(P<0.001)。通过Poisson回归分析控制相关因素后, 地区因素方面, 庆阳市、白银市、定西市和临夏州的VAP发病风险低于兰州市(P<0.05), 而张掖市和嘉峪关市的VAP发病风险较高(P<0.05)。季度因素分析显示, VAP发病率呈季度性波动, 第二季度和第四季度的VAP发病率较高, 但不同季度之间的VAP发生风险无统计学差异。
    结论 甘肃省2023年VAP发病率与之前相比有所降低, 但仍存在一定地区差异, 三级医院和综合医院的发病率相对较高, 因此应加强相关地区的监测, 并采取积极防控措施, 降低VAP发病率。

     

    Abstract:
    OBJECTIVE To retrospectively analyze the prevalence of ventilator-associated pneumonia (VAP) in Gansu Province in 2023 so as to provide scientific bases for formulating and optimizing prevention and control strategies for VAP in the health care institutions of the province.
    METHODS The data regarding to VAP of 2023 were collected from the regional surveillance platform of Gansu Province Nosocomial Infection Management Quality Control Center. The influencing factors for the VAP were assessed by means of Poisson regression model.
    RESULTS In 2023, the median incidence of VAP was 3.51‰ among the 93 hospitals in Gansu Province. There was significant difference in the incidence of VAP among the different regions, levels and types of hospitals (P < 0.05). The length of hospital stay and ventilator treatment duration of the tertiary hospitals were 3458(1904, 6770) days and 1 274(740, 2040)days, respectively, higher than those of the secondary hospitals; the incidence of VAP was 4.89(2.82, 7.40)‰ in the tertiary hospitals, higher than that in the secondary hospitals (all P < 0.05). The incidence of VAP of the general hospitals was 3.94 (2.66, 6.92)‰, higher than 2.06 (1.03, 3.27)‰ of the specialized hospitals (P < 0.001). With the respect to the regional factor, Qingyang City, Baiyin City, Dingxi City and Linxia City were at lower risk of VAP than Lanzhou City after the related factors were controlled through Poisson regression analysis (P < 0.05), while Zhangye City and Jiayuguan City were at higher risk of VAP (P < 0.05). The analysis of seasonal factors showed that the incidence of VAP presented seasonal fluctuation, the incidence of VAP was higher in the second and fourth quarters; however, there was no significant difference in the risk of VAP among the quarters.
    CONCLUSIONS The incidence of VAP is decreased in Gansu Province in 2023 as compared with that in previous years, however, there is certain difference among the different regions. The incidence rates of VAP are relatively high in the tertiary hospitals and the general hospitals. It is necessary to strengthen the surveillance in related areas and take active prevention and control measures, so as to reduce the incidence of VAP.

     

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