López-Cruz Ian, Esparcia Ana, Madrazo Manuel, Alberola Juan, Eiros José María, Artero Arturo
Department of Internal Medicine, Dr. Peset University Hospital, Valencia, Spain.
Department of Internal Medicine, Dr. Peset University Hospital, University of Valencia, Valencia, Spain.
Heliyon. 2022 Oct 18;8(10):e11131. doi: 10.1016/j.heliyon.2022.e11131. eCollection 2022 Oct.
This study aimed to evaluate clinically significant sex differences that could have an effect on the choice of treatment and outcomes of urinary tract infection (UTI) in aged 80 and over hospitalized patients with community-acquired UTI.
This was a prospective study of 161 patients aged 80 and over admitted to hospital with community-acquired UTI. Epidemiological, clinical, laboratory and microbiologic variables were compared between both sexes. Multivariate analysis was performed using logistic regression to determine the variables independently associated with sex.
In a population of 91 (56.52%) women and 70 (43.48%) men, aged 80 and over, we found that women were more likely to have cognitive impairment (p = 0.035) and less likely to have chronic obstructive pulmonary disease (COPD) (p = 0.006) and indwelling urinary catheter (p < 0.001) than men. Levels of creatinine were higher in men than in women (p = 0.008). Septic shock at presentation was more frequent in the male group (p = 0.043). Men had a higher rate of polymicrobial infection (p = 0.035) and infection (p = 0.003). Factors independently associated with sex by multivariate analysis were septic shock, cognitive impairment, COPD and indwelling urinary catheter.
Men aged 80 and over with community-acquired UTI had more septic shock at admission to hospital and higher rates of indwelling urinary catheter, while women had more cognitive impairment. There were no differences in outcomes between sexes.
本研究旨在评估可能影响80岁及以上社区获得性尿路感染住院患者治疗选择和预后的临床显著性别差异。
这是一项对161例80岁及以上社区获得性尿路感染住院患者的前瞻性研究。对男女患者的流行病学、临床、实验室和微生物学变量进行了比较。采用逻辑回归进行多变量分析,以确定与性别独立相关的变量。
在91名(56.52%)女性和70名(43.48%)男性组成的80岁及以上人群中,我们发现女性比男性更易出现认知障碍(p = 0.035),而患慢性阻塞性肺疾病(COPD)(p = 0.006)和留置导尿管(p < 0.001)的可能性较小。男性的肌酐水平高于女性(p = 0.008)。男性组中出现感染性休克的情况更频繁(p = 0.043)。男性的多重微生物感染率(p = 0.035)和感染率(p = 0.003)更高。多变量分析显示与性别独立相关的因素包括感染性休克、认知障碍、COPD和留置导尿管。
80岁及以上社区获得性尿路感染男性患者入院时感染性休克更多,留置导尿管率更高,而女性则有更多认知障碍。两性之间的预后无差异。