Akiyama Yutaro, Saito Sho, Tsuzuki Shinya, Mezaki Kazuhisa, Ohmagari Norio
Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan.
Glob Health Med. 2024 Feb 29;6(1):77-82. doi: 10.35772/ghm.2023.01122.
This study aimed to investigate differences in Activities of Daily Living (ADL), at admission and discharge, as well as the medical costs of pyelonephritis in older adults in Japan. Patients hospitalized for pyelonephritis between January 1, 2013 and March 31, 2019, were retrospectively enrolled. The inclusion criteria were urine culture within 48 h of admission with > 104 colony-forming units/mL of and symptoms of pyelonephritis. Patients were divided into Young (20-64 years), Pre-old (65-74 years), Old (75-84 years), and Super-old (≥ 85 years). ADL and medical costs were compared. Finally, 393 patients were included: 112 (28.5%) were Young, 72 (18.3%) were Pre-old, 130 (33.1 %) were Old, and 79 (20.1%) were Super-old between January 1, 2013, and March 31, 2019. The median differences between Barthel Index (BI) scores, which indicates ADL, at admission and discharge were 0, 0, 25, and 23 in each age group, respectively ( < 0.001). No significant differences existed between the groups aged ≥ 65. Median medical costs were $3,368, $4,894, $5,372, and $6,078 for each age group, respectively ( < 0.001). Medical costs per day did not differ significantly between the groups ( = 0.163). Pyelonephritis due to in patients aged ≥ 75 is associated with a decline in ADL, longer hospital stays, and higher medical costs compared to that in young patients. Pre-old patients did not have lower ADL; however, they tended to have longer hospital stays and higher medical costs.
本研究旨在调查日本老年人肾盂肾炎患者入院时和出院时日常生活活动能力（ADL）的差异以及医疗费用。回顾性纳入了2013年1月1日至2019年3月31日期间因肾盂肾炎住院的患者。纳入标准为入院后48小时内尿培养菌落形成单位>104/mL且有肾盂肾炎症状。患者分为青年组（20 - 64岁）、准老年组（65 - 74岁）、老年组（75 - 84岁）和高龄老年组（≥85岁）。比较了ADL和医疗费用。最终，纳入393例患者：在2013年1月1日至2019年3月31日期间，112例（28.5%）为青年组，72例（18.3%）为准老年组，130例（33.1%）为老年组，79例（20.1%）为高龄老年组。各年龄组入院时和出院时表示ADL的巴氏指数（BI）评分的中位数差异分别为0、0、25和23（P<0.001）。≥65岁的组间无显著差异。各年龄组的医疗费用中位数分别为3368美元、4894美元、5372美元和6078美元（P<0.001）。各组间每日医疗费用无显著差异（P = 0.163）。与年轻患者相比，≥75岁患者因[具体病原体未提及]导致的肾盂肾炎与ADL下降、住院时间延长和医疗费用增加有关。准老年患者的ADL并不低；然而，他们往往住院时间更长且医疗费用更高。
