Thangrom Warin, Roopsawang Inthira, Aree-Ue Suparb
Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Geriatrics (Basel). 2023 Feb 28;8(2):33. doi: 10.3390/geriatrics8020033.
Urinary tract infections are the most common complication after surgery in older adults, resulting in poor operative outcomes and reduced quality of life after discharge. However, there is limited research investigating the relationships between urinary tract infection and associated factors in frail older surgical patients, particularly in Thailand. This retrospective study included 220 frail older patients aged ≥ 60 years who had undergone major noncardiac surgery at a tertiary care hospital in Thailand from January 2015 to December 2019. The sample was recruited using the criteria indicated in the modified Frailty Index-11 and having the blood glucose level determined within 2 h before surgery. The prevalence of lower urinary tract infections was 15% post-surgery. Firth's logistic regression analysis revealed that the equation could predict the accuracy of lower urinary tract infections by 88.5%. Frailty, blood glucose levels, complication during admission, and personal factors together predicted the variability of lower urinary tract infections. Adjusting for other variables, being an older adult with severe frailty and complications during hospital admission significantly increased the risk of developing lower urinary tract infections (odds ratio = 3.46, < 0.05; odds ratio = 9.53, < 0.001, respectively).
尿路感染是老年人术后最常见的并发症，会导致手术效果不佳以及出院后生活质量下降。然而，针对体弱老年手术患者，尤其是泰国的此类患者，研究尿路感染与相关因素之间关系的研究有限。这项回顾性研究纳入了220名年龄≥60岁的体弱老年患者，他们于2015年1月至2019年12月在泰国一家三级护理医院接受了非心脏大手术。样本是根据改良的衰弱指数-11中规定的标准招募的，并在手术前2小时内测定了血糖水平。术后下尿路感染的患病率为15%。费思逻辑回归分析显示，该方程可预测下尿路感染的准确率为88.5%。衰弱、血糖水平、住院期间的并发症以及个人因素共同预测了下尿路感染的变异性。在调整其他变量后，作为严重体弱的老年人且住院期间出现并发症，显著增加了发生下尿路感染的风险（优势比分别为3.46，<0.05；优势比为9.53，<0.001）。
