人群中，患有痴呆症的患者发生尿路感染的发病率和相关死亡率。
Population incidence and associated mortality of urinary tract infection in people living with dementia.
机构信息
UK Dementia Research Institute Care Research and Technology Centre (UK DRI CR&T) at Imperial College London and the University of Surrey, Imperial College London, White City Campus, 86 Wood Lane, London W12 0BZ, UK; Department of Brain Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
UK Dementia Research Institute Care Research and Technology Centre (UK DRI CR&T) at Imperial College London and the University of Surrey, Imperial College London, White City Campus, 86 Wood Lane, London W12 0BZ, UK; Perioperative and Ageing Group, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
出版信息
J Infect. 2024 Jun;88(6):106167. doi: 10.1016/j.jinf.2024.106167. Epub 2024 Apr 26.
OBJECTIVES
Urinary tract infections (UTIs) frequently cause hospitalisation and death in people living with dementia (PLWD). We examine UTI incidence and associated mortality among PLWD relative to matched controls and people with diabetes and investigate whether delayed or withheld treatment further impacts mortality.
METHODS
Data were extracted for n = 2,449,814 people aged ≥ 50 in Wales from 2000-2021, with groups matched by age, sex, and multimorbidity. Poisson regression was used to estimate incidences of UTI and mortality. Cox regression was used to study the effects of treatment timing.
RESULTS
UTIs in dementia (HR=2.18, 95 %CI [1.88-2.53], p < .0) and diabetes (1.21[1.01-1.45], p = .035) were associated with high mortality, with the highest risk in individuals with diabetes and dementia (both) (2.83[2.40-3.34], p < .0) compared to matched individuals with neither dementia nor diabetes. 5.4 % of untreated PLWD died within 60 days of GP diagnosis-increasing to 5.9 % in PLWD with diabetes.
CONCLUSIONS
Incidences of UTI and associated mortality are high in PLWD, especially in those with diabetes and dementia. Delayed treatment for UTI is further associated with high mortality.
目的
尿路感染（UTI）常导致痴呆症患者（PLWD）住院和死亡。我们研究了 PLWD 与匹配对照人群和糖尿病患者相比，UTI 的发病率和相关死亡率，并调查了治疗是否延迟或被拒绝是否会进一步影响死亡率。
方法
从 2000 年至 2021 年，从威尔士年龄≥50 岁的 2449814 人中提取数据，通过年龄、性别和多种合并症进行分组匹配。使用泊松回归估计 UTI 发病率和死亡率。使用 Cox 回归研究治疗时机的影响。
结果
痴呆症（HR=2.18，95%CI [1.88-2.53]，p<.0）和糖尿病（1.21[1.01-1.45]，p=0.035）患者的 UTI 与高死亡率相关，而患有糖尿病和痴呆症的个体（两者）的风险最高（均为）（2.83[2.40-3.34]，p<.0）与没有痴呆症或糖尿病的匹配个体相比。未经治疗的 PLWD 中有 5.4%在全科医生诊断后 60 天内死亡，患有糖尿病的 PLWD 中有 5.9%。
结论
PLWD 的 UTI 发生率和相关死亡率很高，尤其是患有糖尿病和痴呆症的患者。UTI 治疗的延迟与高死亡率进一步相关。
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