Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Department of Surgery, Changhua Christian Hospital, Changhua 500, Taiwan.
Int J Environ Res Public Health. 2021 May 3;18(9):4868. doi: 10.3390/ijerph18094868.
Patients with pelvic fractures could encounter various complications during or after treatments. This cohort study investigated the risk of mortality and readmissions in patients with pelvic fractures, with or without urinary tract infections (UTIs), within 30 days following the pelvic fractures. This retrospective cohort study examined claim records from the Longitudinal Health Insurance Database 2000 (LHID2000). We selected patients hospitalized with pelvic fractures between 1997 and 2013 for study. Patients who had index data before 2000 or after 2010 ( 963), who died before the index date ( 64), who were aged <18 years ( 94), or who had a pelvic injury ( 31) were excluded. In total, the study cohort comprised 1623 adult patients; 115 had UTIs, and 1508 patients without UTIs were used as a comparison cohort. Multivariate analysis with a multiple Cox regression model and Kaplan-Meier survival analysis were performed to analyze the data. Our results showed that the 1-year mortality rate (adjusted hazard ratio [HR]: 2.32; 95% CI: 1.25-4.29) and readmission rate (adjusted HR: 1.72; 95% CI: 1.26-3.34) of the UTI group were significantly higher than those of the non-UTI group. Moreover, the Kaplan-Meier curve for the 1-year follow-up indicated that the UTI group had a higher cumulative risk of both mortality and hospital readmission compared with the non-UTI group. In conclusion, among patients with pelvic fracture, patients with UTI were associated with increased risks of mortality and readmission. Physicians must pay more attention to such patients to prevent UTIs among patients with pelvic fractures during hospitalization and conduct a follow-up after discharge within at least 1 year.
患有骨盆骨折的患者在治疗过程中或之后可能会遇到各种并发症。本队列研究调查了骨盆骨折患者在骨盆骨折后 30 天内合并或不合并尿路感染 (UTI) 的死亡率和再入院风险。这项回顾性队列研究分析了来自 1997 年至 2013 年住院的骨盆骨折患者的索赔记录。我们选择了在 2000 年之前或之后 2010 年（963 人）、在索引日期之前死亡（64 人）、年龄 <18 岁（94 人）或有骨盆损伤（31 人）的患者进行排除。最终，研究队列共纳入了 1623 名成年患者；115 人患有 UTI，1508 人未患有 UTI 作为对照队列。使用多变量 Cox 回归模型和 Kaplan-Meier 生存分析进行数据分析。结果显示，UTI 组的 1 年死亡率（校正后的危险比 [HR]：2.32；95%置信区间 [CI]：1.25-4.29）和再入院率（校正后的 HR：1.72；95% CI：1.26-3.34）明显高于非 UTI 组。此外，1 年随访的 Kaplan-Meier 曲线表明，与非 UTI 组相比，UTI 组的死亡率和医院再入院的累积风险更高。总之，在骨盆骨折患者中，患有 UTI 的患者死亡率和再入院率增加。医生必须更加关注这些患者，以防止住院期间骨盆骨折患者发生 UTI，并在出院后至少 1 年内进行随访。
