1Veterans Affairs Western New York Healthcare System, Buffalo, New York.
Sr Care Pharm. 2021 Dec 1;36(12):681-686. doi: 10.4140/TCP.n.2021.681.
To examine mortality and hospital readmission rates in male veterans with dementia diagnosed with urinary tract infection (UTI) compared with patients without dementia. Retrospective cohort study. Veterans Healthcare Systems (VA). Male inpatients with a diagnosis of UTI who were treated at any VA Healthcare Center from January 1, 2009, to December 31, 2018. None. Mortality and hospital readmission for patients with and without dementia at 30, 60, and 90 days from UTI diagnosis. 262,515 veterans admitted with UTI were analyzed, and 58,940 (22.5%) had dementia. The mean age for veterans with dementia was 80.0 +/- 9.7 years. Veterans with dementia experienced less mortality than patients without dementia at 30 days (8.3% vs 8.5%; < 0.001), but more mortality at 60-day (4.9% vs 4.7%; < 0.001) and 90-day (3.6% vs 3.3%; < 0.001) intervals. Death was 20% less likely at 30 days in patients with dementia. Veterans with dementia were readmitted more than those without dementia at 30-day (18.4% vs 16.0%), 60-day (4.5% vs 2.8%), and 90-day (3.4% vs 2.5%) intervals; < 0.0001. Though patients with dementia are at an increased risk for death long-term, risk of death is less than those without dementia shortly following UTI diagnosis. This highlights the possibility that veterans with dementia may be hospitalized and diagnosed with UTIs when in actuality they have asymptomatic bacteriuria. Patients with dementia and UTI therefore represent an important group of geriatric patients that could benefit from the oversight of a senior care pharmacist to help prevent unnecessary treatment of asymptomatic bacteriuria.
比较诊断为尿路感染（UTI）的痴呆男性退伍军人与无痴呆患者的死亡率和住院再入院率。
回顾性队列研究。
退伍军人医疗保健系统（VA）。
2009 年 1 月 1 日至 2018 年 12 月 31 日期间在任何 VA 医疗保健中心接受治疗的诊断为 UTI 的男性住院患者。
无。
痴呆患者和无痴呆患者在 UTI 诊断后 30、60 和 90 天的死亡率和住院再入院率。
分析了 262515 名患有 UTI 的退伍军人，其中 58940 名（22.5%）患有痴呆症。痴呆症退伍军人的平均年龄为 80.0+/-9.7 岁。与无痴呆症患者相比，痴呆症退伍军人在 30 天内死亡率较低（8.3%对 8.5%；<0.001），但在 60 天（4.9%对 4.7%；<0.001）和 90 天（3.6%对 3.3%；<0.001）间隔的死亡率更高。痴呆症患者在 30 天内死亡的风险降低了 20%。痴呆症退伍军人的再入院率高于无痴呆症退伍军人，30 天（18.4%对 16.0%）、60 天（4.5%对 2.8%）和 90 天（3.4%对 2.5%）；<0.0001。尽管痴呆症患者在长期内死亡风险较高，但在 UTI 诊断后短期内的死亡风险低于无痴呆症患者。这突出表明，患有痴呆症的退伍军人可能在实际上无症状菌尿的情况下因无症状菌尿而住院并被诊断为 UTI。因此，患有痴呆症和 UTI 的患者代表了一个重要的老年患者群体，他们可以受益于高级护理药剂师的监督，以帮助预防无症状菌尿的不必要治疗。
