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预测卒中患者尿路感染(UTI)的简易评分系统的开发。

The Development of Simple Scoring System to Predict Urinary Tract Infection (UTI) in Patients with Stroke.

作者信息

Pak In-Hui, Han Se-Ryong, Sin Chol-Ho, Kim Hyo-Song, Rim Un-Ryong

机构信息

Faculty of Biomedical Engineering, Kim Chaek University of Technology, Pyongyang, Democratic People's Republic of Korea.

Neurology Department, Pyongyang Medical College Hospital, Pyongyang, Democratic People's Republic of Korea.

出版信息

Int J Endocrinol. 2024 May 27;2024:2512824. doi: 10.1155/2024/2512824. eCollection 2024.

Abstract

Urinary tract infection is a frequent problem after stroke. Although prior scoring systems for UTI after stroke have been developed, we developed a simple scoring system for all types of stroke in our own. The study was designed on retrospective data. The population includes 1496 patients with stroke who had been admitted at the Neurology Department of Pyongyang Medical College Hospital between January 2010 and August 2019. The patients were diagnosed with confirmed CT and MRI. Urinary tract infection (UTI) was diagnosed through urine culture: more than 100,100 colony-forming units per millimeter in patients with signs and symptoms. The UTI prediction scoring system was developed by means of the variables available on admission. The variables with significant difference between the non-UTI group and the UTI group were age (non-UTI versus UTI, 56.4 ± 7.2 vs. 59.0 ± 12.8; < 0.001), female (244 (24.2) vs. 176 (36.1), < 0.001), 300 ≦ SI (smoking index) (16 (2.4) vs. 48 (12.0), < 0.001), alcohol > 25 g/d (292 (29.0) vs. 184 (37.7), < 0.001), poststroke hyperglycemia (120 (10.3) vs. 163 (33.4), < 0.001), indwelling of urinary catheter (157 (15.6) vs. 351 (72.0), < 0.001), GCS (Glasgow Coma Scale) on admission (11.2 ± 3.9 vs. 8.5 ± 4.0, = 0.038), and WFNS (World Federation of Neurosurgeons) (in subarachnoid hemorrhage) on admission (2.9 ± 1.7 vs. 3.5 ± 1.5, < 0.001). The UTI prediction score ranged from 0 to 8 and produced an AUC (area under curve) of 0.800. The optimal cutoff point was 2.5 (sensitivity 64.3% and specificity 79.9%). So, the score ≧ 3 was the optimal score for the prediction of UTI after stroke.

摘要

尿路感染是中风后的常见问题。尽管之前已经开发了中风后尿路感染的评分系统,但我们自行开发了一种适用于所有类型中风的简单评分系统。该研究基于回顾性数据设计。研究人群包括2010年1月至2019年8月期间在平壤医学院附属医院神经科住院的1496例中风患者。这些患者通过CT和MRI确诊。尿路感染(UTI)通过尿培养诊断:有症状和体征的患者每毫米菌落形成单位超过100,100个。UTI预测评分系统通过入院时可用的变量开发。非UTI组和UTI组之间有显著差异的变量包括年龄(非UTI组与UTI组,56.4±7.2对59.0±12.8;<0.001)、女性(244例(24.2%)对176例(36.1%),<0.001)、吸烟指数(SI)≥300(16例(2.4%)对48例(12.0%),<0.001)、酒精摄入量>25克/天(292例(29.0%)对184例(37.7%),<0.001)、中风后高血糖(120例(10.3%)对163例(33.4%),<0.001)、留置导尿管(157例(15.6%)对351例(72.0%),<0.001)、入院时格拉斯哥昏迷量表(GCS)评分(11.2±3.9对8.5±4.0,P = 0.038)以及蛛网膜下腔出血患者入院时世界神经外科医师联盟(WFNS)评分(2.9±1.7对3.5±1.5,<0.001)。UTI预测评分范围为0至8,曲线下面积(AUC)为0.800。最佳截断点为2.5(敏感性64.3%,特异性79.9%)。因此,评分≥3是中风后UTI预测的最佳评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b5/11390227/3a164231eddc/IJE2024-2512824.001.jpg

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