An Jinjoo, Choi Seung Pill, Oh Jae Hun, Zhu Jong Ho, Kim Sung Wook, Kim Soo Hyun
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Department of Emergency, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
J Clin Med. 2023 Jul 31;12(15):5024. doi: 10.3390/jcm12155024.
The occurrence of a critical event during a urinary tract infection (UTI) can have a significant impact on mortality. This study aimed to investigate the association between the skeletal muscle index (SMI) and critical events in patients with a UTI. From April 2019 to March 2022, a total of 478 patients who met the diagnostic criteria of a UTI and underwent an abdominal CT were included in this study. Multivariate binary logistic regression analysis was used to assess independent predictors of critical events. The primary outcome was any critical event, defined as the initiation of dialysis, invasive ventilation, initiation of vasoactive medications, cardiac arrest, or death. The UTI patients were divided into two groups: those with a low SMI (n = 93) and those with a high SMI (n = 385). In multivariate analysis, a low SMI, diabetes mellitus, altered mentality, lactate levels, and creatinine levels were identified as significant predictors of critical events. A low SMI is an independent factor associated with the occurrence of critical events in UTI patients during hospitalization. Patients with a low SMI, indicating muscle wasting, may have less resilience to infections and a higher risk of experiencing severe complications. Considering the SMI along with other clinical factors can help health care providers assess and manage UTI patients.
尿路感染(UTI)期间发生的危急事件可能对死亡率产生重大影响。本研究旨在调查尿路感染患者的骨骼肌指数(SMI)与危急事件之间的关联。2019年4月至2022年3月,本研究共纳入478例符合尿路感染诊断标准并接受腹部CT检查的患者。采用多因素二元逻辑回归分析评估危急事件的独立预测因素。主要结局为任何危急事件,定义为开始透析、有创通气、开始使用血管活性药物、心脏骤停或死亡。尿路感染患者分为两组:SMI低的患者(n = 93)和SMI高的患者(n = 385)。在多因素分析中,低SMI、糖尿病、意识改变、乳酸水平和肌酐水平被确定为危急事件的显著预测因素。低SMI是尿路感染患者住院期间发生危急事件的独立相关因素。SMI低表明肌肉萎缩的患者可能对感染的恢复力较低,发生严重并发症的风险较高。综合考虑SMI以及其他临床因素有助于医护人员评估和管理尿路感染患者。