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中国卧床不动住院患者尿路感染的患病率、发病率和危险因素:一项前瞻性、多中心研究。

Prevalence, incidence, and risk factors of urinary tract infection among immobile inpatients in China: a prospective, multi-centre study.

机构信息

Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, China.

出版信息

J Hosp Infect. 2020 Apr;104(4):538-544. doi: 10.1016/j.jhin.2019.11.018. Epub 2019 Nov 29.

Abstract

BACKGROUND

Immobile inpatients have a high risk of urinary tract infection (UTI). Additional epidemiological data regarding UTIs among immobile inpatients are needed.

AIM

To investigate the prevalence and incidence of, and risk factors for, UTIs among immobile patients in 25 hospitals throughout China.

METHODS

This was a national multi-centre cross-sectional investigation. We recruited six tertiary hospitals, 12 non-tertiary hospitals, and seven community hospitals. We obtained data regarding demographics, clinically related variables, and UTI-specific variables from immobile patients during their hospitalization. We performed univariate and multivariable analyses, and binary logistic regression analysis was used to identify risk factors.

FINDINGS

Among 23,985 immobile patients, 393 had a UTI. The prevalence and incidence of UTIs in hospitalized immobile patients was 1.64% (393/23 985) and 0.69 per 1000 patient-days, respectively. The infection rate of catheter-associated UTI was 2.25 per 1000 urinary catheter-days. We found that a greater number of bedridden days, longer length of hospital stay, being in a medical ward, the presence of an indwelling urethral catheter, prolonged duration of an indwelling catheter, use of glucocorticoids, female sex, diabetes mellitus, and older age were independent risk factors of UTI.

CONCLUSION

Immobile patients had similar risk factors for UTI as the general population, as well as some additional risk factors. Greater attention is needed in the management of UTIs among the population of immobile hospitalized patients.

摘要

背景

卧床不动的住院患者有发生尿路感染(UTI)的高风险。需要更多有关卧床不动的住院患者 UTI 的流行病学数据。

目的

调查中国 25 家医院中卧床不动患者 UTI 的患病率、发病率和危险因素。

方法

这是一项全国多中心横断面调查。我们招募了六家三级医院、12 家非三级医院和七家社区医院。我们从住院期间的卧床不动患者那里获得了人口统计学、与临床相关的变量以及 UTI 特定变量的数据。我们进行了单变量和多变量分析,并使用二元逻辑回归分析来确定危险因素。

结果

在 23985 名卧床不动的患者中,有 393 名患有 UTI。住院卧床不动患者 UTI 的患病率和发病率分别为 1.64%(393/23985)和 0.69/1000 患者日。导尿管相关 UTI 的感染率为每 1000 个导尿管日 2.25 例。我们发现,卧床天数增加、住院时间延长、在医疗病房、留置导尿管、留置导尿管时间延长、使用糖皮质激素、女性、糖尿病和年龄较大是 UTI 的独立危险因素。

结论

卧床不动的住院患者发生 UTI 的危险因素与一般人群相似,还有一些其他的危险因素。需要更加重视管理卧床不动的住院患者的 UTI。

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