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复发性下尿路感染:不仅仅是老年女性的感染问题。

Recurrent lower urinary tract infections: more than an infection for older women.

机构信息

Department of Internal Medicine, Division of Geriatric Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye Turkiye.

出版信息

Turk J Med Sci. 2023 May 9;53(5):1395-1403. doi: 10.55730/1300-0144.5706. eCollection 2023.

Abstract

BACKGROUND/AIM: Older adults tend to have more urinary tract infections (UTIs). The frequency of recurrent lower urinary tract infections (rLUTIs) increases with age. rLUTIs are associated with long-term chronic effects on geriatric syndromes in older adults. We aimed to investigate possible risk factors that influence rLUTIs in older adults based on comprehensive geriatric assessment (CGA).

MATERIALS AND METHODS

This cross-sectional study included 235 older adults admitted to Gaziantep University's Geriatric Outpatient Clinic between June 1 and November 30, 2022. All patients underwent CGA. The Geriatric Depression Scale (GDS), the European Quality of Life-Five Dimension (EQ-5D) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Katz Index of Activities of Daily Living (ADL), the Lawton and Brody Index of Instrumental Activities of Daily Living (IADL), and the Mini Nutritional Assessment (MNA) tool were,administered. Handgrip strength (HGS) and gait speed were also measured, and the number of falls in the last year was recorded.

RESULTS

The mean age of the participants was 72.8 ± 6.8 years and 61.3% were female. Sixty-four patients had rLUTIs. The rLUTI group had higher frequencies of sarcopenia, hypertension, and diabetes; higher numbers of comorbidities and medications; higher GDS and PSQI scores; and more reported falls. They had lower ADL, MNA, EQ-5D, and gait speed scores. HGS was found to be lower in women with rLUTIs. Higher numbers of comorbidities and GDS scores and lower HGS were independent predictors of rLUTIs in women (p = 0.011, OR: 1.75; p = 0.018, OR: 1.14; and p = 0.042, OR: 0.91, respectively).

CONCLUSION

We revealed that decreased HGS, higher GDS, and the number of comorbidities in older women were independent risk factors for rLUTIs. Our findings offer a new perspective on the importance of CGA in diagnosing and preventing rLUTIs.

摘要

背景/目的:老年人往往更容易发生尿路感染(UTI)。复发性下尿路感染(rLUTI)的频率随年龄增长而增加。rLUTI 与老年人老年综合征的长期慢性影响有关。我们旨在根据综合老年评估(CGA)研究影响老年人 rLUTI 的可能危险因素。

材料和方法

这项横断面研究纳入了 2022 年 6 月 1 日至 11 月 30 日期间在加济安泰普大学老年门诊就诊的 235 名老年人。所有患者均接受 CGA。使用老年抑郁量表(GDS)、欧洲生活质量五维问卷(EQ-5D)、匹兹堡睡眠质量指数(PSQI)、Katz 日常生活活动量表(ADL)、Lawton 和 Brody 日常生活活动工具量表(IADL)和微型营养评估(MNA)进行评估。还测量了手握力(HGS)和步态速度,并记录了过去一年的跌倒次数。

结果

参与者的平均年龄为 72.8 ± 6.8 岁,61.3%为女性。64 名患者患有 rLUTI。rLUTI 组肌肉减少症、高血压和糖尿病的发病率更高;合并症和药物的数量更多;GDS 和 PSQI 评分更高;报告的跌倒次数更多。他们的 ADL、MNA、EQ-5D 和步态速度评分较低。患有 rLUTI 的女性 HGS 较低。女性 rLUTI 的独立预测因素包括合并症数量较多、GDS 评分较高和 HGS 较低(p=0.011,OR:1.75;p=0.018,OR:1.14;p=0.042,OR:0.91)。

结论

我们发现,老年女性 HGS 降低、GDS 升高和合并症数量增加是 rLUTI 的独立危险因素。我们的研究结果提供了一个新的视角,即 CGA 在诊断和预防 rLUTI 方面的重要性。

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