Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, Lancashire, UK.
Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, Lancashire, UK; School of Medicine, University of Central Lancashire, Preston, Lancashire, UK.
J Hosp Infect. 2023 Sep;139:56-66. doi: 10.1016/j.jhin.2023.06.016. Epub 2023 Jun 19.
There is no consensus regarding whether urinary tract infection (UTI) should be screened for or treated in hip fracture patients.
To assess the relationship between perioperative UTI and surgical site infection (SSI) in hip fracture patients, and the relationship between urinary catheterization and SSI in these patients.
PubMed, Embase, CINAHL and Cochrane Library were searched to identify studies that evaluated the relationship between perioperative UTI and SSI and/or between urinary catheterization and SSI. Articles were included if they used the term UTI or specified UTI as symptomatic bacteriuria.
A total of 4139 records were identified, with eight studies included. Meta-analysis of seven studies which evaluated perioperative UTI and SSI showed an SSI rate of 7.1% (95% confidence interval (CI): 3.8-13.2) among 1217 patients with UTI vs 2.4% (95% CI: 1.0-5.7) in 36,514 patients without UTI (OR: 2.41; 95% CI: 1.67-3.46; P < 0.001). In three studies which specifically defined UTI as symptomatic bacteriuria, the SSI rate among UTI patients was 5.7% (95% CI: 4.0-8.1) vs 1.1% (95% CI: 0.2-5.2) in those without UTI (OR: 3.00; 95% CI: 0.55-16.26; P = 0.20). One study evaluated urinary catheterization and SSI.
Perioperative UTI is associated with a higher risk of SSI among hip fracture patients but the evidence is limited by the heterogeneity in the definition of UTI. We recommend considering the possibility of perioperative UTI in hip fracture patients, with treatment administered as necessary to reduce SSI rates.
对于髋部骨折患者，是否应该筛查或治疗尿路感染（UTI）尚无共识。
评估髋部骨折患者围手术期 UTI 与手术部位感染（SSI）之间的关系，以及这些患者中导尿与 SSI 之间的关系。
检索 PubMed、Embase、CINAHL 和 Cochrane Library，以确定评估围手术期 UTI 与 SSI 之间以及导尿与 SSI 之间关系的研究。如果文章使用了 UTI 一词或明确规定 UTI 为症状性菌尿，则将其纳入。
共确定了 4139 条记录，纳入了 8 项研究。对 7 项评估围手术期 UTI 和 SSI 的研究进行的荟萃分析显示，1217 例 UTI 患者的 SSI 发生率为 7.1%（95%可信区间：3.8-13.2），36514 例无 UTI 患者的 SSI 发生率为 2.4%（95%可信区间：1.0-5.7）（OR：2.41；95%可信区间：1.67-3.46；P<0.001）。在 3 项明确将 UTI 定义为症状性菌尿的研究中，UTI 患者的 SSI 发生率为 5.7%（95%可信区间：4.0-8.1），无 UTI 患者的 SSI 发生率为 1.1%（95%可信区间：0.2-5.2）（OR：3.00；95%可信区间：0.55-16.26；P=0.20）。有一项研究评估了导尿与 SSI 之间的关系。
髋部骨折患者围手术期 UTI 与 SSI 风险增加相关，但由于 UTI 的定义存在异质性，证据有限。我们建议考虑髋部骨折患者围手术期 UTI 的可能性，并根据需要进行治疗以降低 SSI 发生率。
