在养老院居民中使用留置导尿管：21 家德国养老院的横断面研究结果。
Use of indwelling urinary catheters in nursing home residents: results from a cross-sectional study in 21 German nursing homes.
机构信息
Department of Health, Long-term Care and Pensions, SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 5, 28359, Bremen, Germany.
High-Profile Area of Health Sciences, University of Bremen, Bibliothekstraße 1, 28359, Bremen, Germany.
出版信息
BMC Urol. 2024 Jun 14;24(1):125. doi: 10.1186/s12894-024-01512-w.
BACKGROUND
Indwelling urinary catheters often lead to complications such as symptomatic urinary tract infections. In nursing home residents, catheter prevalence is high, but prevalence differences by sociodemographic characteristics, comorbidities, and health services use have rarely been investigated. The purpose of this work was to describe the use of indwelling urinary catheters in nursing home residents and to examine whether catheter use is associated with individual characteristics.
METHODS
Cross-sectional data of the "Inappropriate Medication in patients with REnal insufficiency in Nursing homes" (IMREN) study conducted in 21 German nursing homes between October 2014 and April 2015 were analyzed. For all residents of the involved care units, nurses of the participating institutions completed an anonymous questionnaire including the Modified Rankin Scale to assess physical impairments. The proportion of nursing home residents with indwelling urinary catheter was determined. Associations between catheter use and individual characteristics were investigated via cluster-adjusted multivariable logistic regression.
RESULTS
Of 852 residents (76.5% female; mean age 83.5 years), 13.4% had an indwelling urinary catheter. The adjusted odds ratios for catheter use for men vs. women was 2.86 (95% confidence interval 1.82-4.50). For residents with "moderate" disability vs. those with "no to slight" disability it was 3.27 (1.36-7.85), for individuals with "moderately severe" disability vs. the reference group it was 9.03 (3.40-23.97), and for those with "severe" disability vs. the reference group it was 26.73 (8.60-83.14). For residents who had been hospitalized within the last 12 months vs. those without a hospitalization it was 1.97 (1.01-3.87). For age, dementia, overweight/obesity, other indwelling devices, and long-term medications no significant associations were found.
CONCLUSIONS
Male nursing home residents, residents with a higher degree of physical impairment, and those who had been hospitalized within the last 12 months were more likely to use an indwelling urinary catheter than their counterparts. Data on circumstances of and indications for catheters, catheter types, and duration of catheterization are needed to evaluate the appropriateness of catheter use in nursing home residents and the need for interventions.
背景
留置导尿管常导致泌尿道感染等症状。在养老院居民中，留置导尿管的患病率较高，但很少有研究调查社会人口特征、合并症和卫生服务使用方面的患病率差异。本研究的目的是描述养老院居民留置导尿管的使用情况，并探讨其与个体特征的关系。
方法
对 2014 年 10 月至 2015 年 4 月在 21 家德国养老院进行的“不适当药物治疗对养老院肾功能不全患者的影响”（IMREN）研究的横断面数据进行分析。参与机构的护士为参与护理单元的所有居民填写了一份匿名问卷，其中包括 Modified Rankin Scale 以评估身体损伤程度。确定有留置导尿管的养老院居民的比例。通过聚类调整多变量逻辑回归分析导管使用与个体特征之间的关系。
结果
在 852 名居民中（76.5%为女性；平均年龄 83.5 岁），13.4%有留置导尿管。男性使用导尿管的调整比值比为 2.86（95%置信区间 1.82-4.50）。与“无至轻度”残疾的居民相比，“中度”残疾的居民为 3.27（1.36-7.85），与“中度严重”残疾的居民相比，参考组为 9.03（3.40-23.97），与“严重”残疾的居民相比，参考组为 26.73（8.60-83.14）。与过去 12 个月内住院的居民相比，没有住院的居民为 1.97（1.01-3.87）。对于年龄、痴呆、超重/肥胖、其他留置设备和长期药物，没有发现显著的相关性。
结论
男性养老院居民、身体功能障碍程度较高的居民以及过去 12 个月内住院的居民比其对照组更有可能使用留置导尿管。需要了解有关导管使用情况和适应证、导管类型以及导管插入时间的数据，以评估养老院居民留置导尿管的适当性和干预需求。
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