Bower Wendy F, Lau Lisa, Whishaw D Michael, Reijnierse Esmee M, Maier Andrea B
Home First, Complex Care and Ambulatory Services, The Royal Melbourne Hospital (Victoria), Parkville, Victoria, Australia.
Physiotherapy, Department of Allied Health, The Royal Melbourne Hospital (Victoria), Parkville, Victoria, Australia.
Gerontology. 2024;70(12):1284-1293. doi: 10.1159/000542056. Epub 2024 Oct 21.
Nocturnal lower urinary tract symptoms are common in geriatric rehabilitation inpatients but have not been well described. The aim of this study was to compare patient characteristics stratified by self-reported nocturia severity in geriatric rehabilitation inpatients.
The REStORing health of acutely unwell adulTs (RESORT) is an observational, longitudinal, prospective inception cohort of geriatric rehabilitation inpatients who underwent a Comprehensive Geriatric Assessment (CGA) at admission and discharge. Nocturia was captured by item 7 of the American Urology Association Symptom Score (AUASS) and dichotomised as ≤1 void and >1 void at night as per the International Continence Society definition. Differences in demographic, functional, and medical characteristics of the inpatients with and without nocturia >1 were compared.
Overall, 641 inpatients completed the nocturia item (mean age 82.6 [SD 7.7] years, 59.9% female). Nocturia occurred >once per night in 57.4%; mean number of episodes was 1.96 (SD 1.38), ranging from 0 to 5. There was no change in nocturia severity between admission and discharge. Daily urinary incontinence, urinary urgency, and comorbid illness were independently associated with multiple nocturia episodes. A history of falls within the last year, difficulty climbing stairs pre-admission, higher faecal incontinence score, impaired quality of life domains, higher levels of anxiety and depression were significantly more common in inpatients with multiple episodes of nocturia compared to no or only one episode of nocturia.
Lower urinary tract symptoms, poor functional status and frailty markers were associated with repeated episodes of nocturia. Targeted intervention may reduce the severity of nocturia, with potential to improve sleep quality, impact therapeutic gains and influence discharge destination.
夜间下尿路症状在老年康复住院患者中很常见，但尚未得到充分描述。本研究的目的是比较老年康复住院患者中根据自我报告的夜尿严重程度分层的患者特征。
急性不适成人恢复健康（RESORT）是一项观察性、纵向、前瞻性起始队列研究，纳入了老年康复住院患者，这些患者在入院和出院时均接受了综合老年评估（CGA）。夜尿通过美国泌尿外科学会症状评分（AUASS）的第7项进行记录，并根据国际尿失禁学会的定义分为夜间排尿≤1次和>1次。比较了有和没有夜尿>1次的住院患者在人口统计学、功能和医学特征方面的差异。
总体而言，641名住院患者完成了夜尿项目（平均年龄82.6[标准差7.7]岁，59.9%为女性）。57.4%的患者夜间排尿>1次；平均发作次数为1.96（标准差1.38），范围为0至5次。入院和出院之间夜尿严重程度没有变化。每日尿失禁、尿急和合并症与多次夜尿发作独立相关。与没有夜尿发作或仅有一次夜尿发作的患者相比，过去一年内有跌倒史、入院前爬楼梯困难、更高的大便失禁评分、生活质量领域受损、更高水平的焦虑和抑郁在多次夜尿发作的住院患者中明显更为常见。
下尿路症状、功能状态差和虚弱标志物与反复夜尿发作有关。有针对性的干预可能会降低夜尿的严重程度，有可能改善睡眠质量、影响治疗效果并影响出院目的地。
