Abstract：
Hospital Acquired Pneumonia (HAP) is one of the most common complications and late causes of death in TBI patients. Targeted prevention and treatment of HAP are of great significance for improving the prognosis of TBI patients. In the previous clinical observation, we found that folic acid treatment for TBI patients has a good effect on preventing and treating HAP. We conducted this retrospective cohort study to demonstrate what we observed by selecting 293 TBI patients from two medical centers and analyzing their hospitalization data. The result showed that the incidence of HAP was significantly lower in TBI patients who received folic acid treatment (44.1% vs. 63.0%, p = 0.012). Multivariate logistic regression analysis showed that folic acid treatment was an independent protective factor for the occurrence of HAP in TBI patients (OR = 0.418, p = 0.031), especially in high-risk groups of HAP, such as the old (OR: 1.356 vs. 2.889), ICU (OR: 1.775 vs. 5.996) and severe TBI (OR: 0.975 vs. 5.424) patients. At the same time, cohort studies of HAP patients showed that folic acid also had a good effect on delaying the progression of HAP, such as reducing the chance of tracheotomy (26.1% vs. 50.8%, p = 0.041), and reduced the length of hospital stay (15 d vs. 19 d, p = 0.029) and ICU stay (5 d vs. 8 d, p = 0.046). Therefore, we believe that folic acid treatment in TBI patients has the potential for preventing and treating HAP, and it is worthy of further clinical research.
摘要：
医院获得性肺炎（HAP）是TBI患者最常见的并发症和晚期死亡原因之一。HAP的针对性防治对改善TBI患者预后具有重要意义。在以往的临床观察中,我们发现叶酸治疗对TBI患者有很好的预防和治疗HAP的作用。我们进行了这项回顾性队列研究，通过从两个医疗中心选择293名TBI患者并分析其住院数据来证明我们观察到的结果。结果显示，接受叶酸治疗的TBI患者的HAP发生率显着降低（44.1％vs.63.0%,p=0.012)。多因素logistic回归分析显示,叶酸治疗是TBI患者发生HAP的独立保护因素(OR=0.418,p=0.031)。特别是在HAP的高危人群中，例如旧的(OR：1.356vs.2.889),ICU（或：1.775vs.5.996）和严重TBI（OR：0.975vs.5.424）患者。同时,HAP患者的队列研究表明,叶酸对延缓HAP的进展也有很好的作用,例如减少气管切开术的机会(26.1%vs.50.8%,p=0.041),并缩短了住院时间(15dvs.19d,p=0.029)和ICU住院时间(5dvs.8d,p=0.046)。因此,我们认为TBI患者的叶酸治疗具有预防和治疗HAP的潜力，值得进一步临床研究。
