卒中患者尿路感染的患病率及预测因素：一项荟萃分析。

Prevalence and predictive factors of urinary tract infection among patients with stroke: A meta-analysis.

机构信息

Department of Infection Prevention and Control, Qilu Hospital of Shandong University, Jinan, Shandong Province, China; School of Nursing, Shandong University, Jinan, Shandong Province, China.

Department of Infection Prevention and Control, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.

出版信息

Am J Infect Control. 2018 Apr;46(4):402-409. doi: 10.1016/j.ajic.2017.10.001. Epub 2017 Nov 16.

DOI:10.1016/j.ajic.2017.10.001

PMID:29153643

Abstract

BACKGROUND

Urinary tract infection (UTI) is thought to be a common complication of stroke and is regarded as a potential risk factor for poor stroke outcomes. However, there is a controversy among predictive factors of stroke-associated UTIs. We aim to estimate the prevalence and predisposing factors of UTIs among patients with stroke.

METHODS

PubMed, EMBASE, and Elsevier Science Direct were searched by 2 independent researchers. Sixteen studies with a total of 13,513 patients were included to evaluate the prevalence and predictive factors of stroke-associated UTIs published from the earliest records to March 10, 2017. Pooled effect sizes were calculated using the fixed effect model or random effect model according to I and P values.

RESULTS

The pooled prevalence of UTI was 19.0% (95% confidence interval [CI], 15%-22%; P <.01). The predisposing factors for UTIs include female sex (odds ratio [OR], 1.93; 95% CI, 1.55-2.41), older age (OR, 1.28; 95% CI, 1.09-1.50), higher modified Rankin Scale score (OR, 1.90; 95% CI, 1.43-2.53), and postvoid residual volume >100 mL (OR, 3.69; 95% CI, 2.09-6.52).

CONCLUSIONS

Approximately one-fifth of patients with stroke contracted at least 1 UTI after cerebral apoplexy. Female sex, older age, higher modified Rankin Scale score, and postvoid residual volume >100 mL were associated with higher risk of UTI.

摘要

背景

尿路感染（UTI）被认为是中风的常见并发症，被认为是中风预后不良的潜在危险因素。然而，中风相关 UTI 的预测因素存在争议。我们旨在评估中风患者 UTI 的患病率和易患因素。

方法

由 2 名独立研究人员检索 PubMed、EMBASE 和 Elsevier Science Direct。共纳入 16 项研究，总计 13513 例患者，评估了 2017 年 3 月 10 日前发表的与中风相关 UTI 的患病率和预测因素。根据 I 和 P 值，使用固定效应模型或随机效应模型计算合并效应大小。

结果

UTI 的总体患病率为 19.0%（95%置信区间 [CI]，15%-22%；P<.01）。UTI 的易患因素包括女性（比值比 [OR]，1.93；95%CI，1.55-2.41）、年龄较大（OR，1.28；95%CI，1.09-1.50）、改良 Rankin 量表评分较高（OR，1.90；95%CI，1.43-2.53）和残余尿量>100 mL（OR，3.69；95%CI，2.09-6.52）。