Incidence, risk factors and clinical implications of postoperative urinary tract infection in geriatric hip fractures

Saadat, Ghulam H; Alsoof, Daniel; Borjali, Ahmad; Butler, Bennet A.; Messer, Thomas; Bokhari, Faran

doi:10.1016/j.injury.2022.03.012

Cited by 10 publications

(11 citation statements)

References 20 publications

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“…Long surgery times are also associated with greater surgical trauma, thus increasing the risk of urinary tract infection. 25,26 While we detected differences in surgical time between the two groups of patients, further logistic regression analysis did not find that prolonged surgical time was a risk factor for nosocomial infection after FURSLL. This may be related to sample size selection bias, and further research is needed in this regard.…”

Section: Discussioncontrasting

confidence: 56%

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

Xu,

2023

Pak J Med Sci

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Objectives: To construct a predictive model of nosocomial infection in patients with upper urinary tract (UUT) stones after flexible ureterorenoscopy with laser lithotripsy (FURSLL). Methods: Medical records of 196 patients with UUT stones who underwent FURSLL in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from December 2019 to December 2022 were retrospectively analyzed. Patients were divided into infected group or uninfected group based on the presence of infection during postoperative hospitalization. Univariate and multivariate logistic regressions were used to identify risk factors of postoperative nosocomial infections. A nomogram prediction model was constructed using R software. The predictive ability of the model was assessed using the receiver operating characteristic (ROC) curve. Results: A total of 54 patients (27.6%) developed nosocomial infections after FURSLL. Logistic regression analysis showed that older age, diabetes, preoperative urinary system infection, ureteral stricture, hydronephrosis, double J-stent retention time, and stone diameter were risk factors of nosocomial infection. The nomogram model was constructed based on these risk factors. The ROC showed that the area under the curve (AUC) of the model was 0.930 (95% CI: 0.890-0.970), and the sensitivity and specificity were 92.6% and 81.7%, respectively, indicating that the prediction model was effective. Conclusions: Risk of nosocomial infection in patients with UUT stones after FURSLL is affected by older age, diabetes, preoperative urinary system infection, ureteral stenosis, hydronephrosis, double J-stent retention time, and stone diameter. The nomogram prediction model, constructed based on the above factors, has good predictive value. doi: https://doi.org/10.12669/pjms.40.3.8855 How to cite this: Xu Y, Xu P. A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study. Pak J Med Sci. 2024;40(3):---------. doi: https://doi.org/10.12669/pjms.40.3.8855 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussioncontrasting

confidence: 56%

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

Xu,

2023

Pak J Med Sci

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“…Macrophage clearance of respiratory secretions is reduced, leading to aggregation of respiratory secretions and immunological disturbances in lung tissue, and therefore the elderly become less susceptible to resistance to infection by hospital-acquired pathogens [30]. Saadat et al [31] retrospectively analysed 29377 patients with lower limb fractures from 2006-2014, and their results showed age, preoperative with COPD, exertional dyspnoea, and anaemia as independent risk factors for postoperative pneumonia. Lv et al [32] analysed 1429 patients with lower limb fracture in a 2year follow-up and their results showed that advanced age, diabetes mellitus, anaemia, history of stroke, anaesthesia ASA grading, as well as hypo-proteinaemia, high serum creatinine, and erythrocyte distribution width were the independent risk factors for post-operative pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Predicting risk factors for postoperative pneumonia in patients with lower limb fractures based on logistic regression model

Wei,

Xiao,

Lin

et al. 2024

Preprint

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Purpose: Lower limb fracture is a frequent cause of hospitalization, and postoperative pneumonia is an important marker of hospital cost and quality of care provided. As an extension of traditional statistical methods, machine learning provides the possibility of accurately predicting the postoperative pneumonia. The aim of this paper is to retrospectively identify predictive factors of postoperative pneumonia by using multivariate logistic regression model. Methods: The incidence and admission of postoperative pneumonia in patients with lower limb fractures in the Second Affiliated Hospital of Nanchang University from 2017 to 2023 were retrospectively analysed. Patients who developed postoperative pneumonia during hospitalisation were defined as the pneumonia group, and those who did not develop postoperative pneumonia were defined as the no pneumonia group. Then logistic regression model of the postoperative pneumonia was developed and evaluated. Results: The incidence of postoperative pneumonia was 6.44%, and the AUC values was 0.821, indicating that the module could predict the occurrence of postoperative pneumonia to a large extent. Sex, age, smoking history, alcohol consumption history, operation time, cerebrovascular disease, hypertension, diabetes, fracture type, surgical grade, globulin ratio, platelets, and C-reactive protein were identifed as signifcant factors for postoperative pneumonia. Conclusions: Our proposed model corresponding to the predictors is designed to be convenient for clinical use. This model offers promising potential as a tool for the prevention and treatment of postoperative pneumonia in patients with lower limb fractures. Adopting appropriate health management methods may reduce the risk of postoperative pneumonia in patients with lower limb fractures.

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“…Table 1 details the main characteristics of the 44 items included in the study, while Table 2 presents the specific results of the metaanalysis. The following risk factors are crucial for clinical doctors to identify and intervene in the occurrence of UTI: female [9 studies (5, 14-21), OR = 2.23, 95% CI: 1.89-2.63, Figure 2A]; urinary catheterization [4 studies (18,19,22,23), OR = 3.8, 95% CI: 2.29-6.32, Figure 3A]; delirium [6 studies (12,13,18,(24)(25)(26), OR = 2.66, 95% CI: 2.05-3.47, Figure 5A]; dementia [5 articles (5,14,18,27,28), OR = 1.82, 95% CI: 1.62-2.06, Figure 5B]; history of sepsis [2 articles (7,15), OR = 7.13, 95% CI: 5.51-9.22, Figure 6A].…”

Section: Potential Risk Factorsmentioning

confidence: 99%

“…Unfortunately, the elderly population afflicted with hip fractures is plagued by a multitude of pre-existing conditions, physical deterioration, and prolonged immobilization, thus yielding a complication rate ranging from 7% to 40% (5). Among these complications, UTI stands out as a prominent affliction afflicting hip fracture patients, with occurrence rates ranging from 4% to 32% (6,7). The grave implications of UTIs are correlated with elevated mortality rates, profound disabilities, and escalated healthcare expenditures, ultimately dealing an irrevocable blow to the already vulnerable elderly hip fracture population.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for urinary tract infection in geriatric hip fracture patients: a systematic review and meta-analysis

Wang,

Yao,

Tang

et al. 2024

Front. Med.

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BackgroundUrinary tract infection (UTI) is a prevalent and consequential complication in hip fracture patients, leading to significant disability and heightened healthcare expenditures. Consequently, there is a critical need for a comprehensive systematic review to identify risk factors and establish early and effective preventive measures.MethodsA comprehensive search was performed across the PubMed, Cochrane, Embase, Web of Science, and Scopus databases (up to August 31, 2023). Article screening, data extraction, and quality assessment were independently completed by two reviewers.ResultsForty-four studies were eligible for inclusion, yielding an overall incidence rate of 11% (95% CI: 8%−14%). Our pooled analysis revealed 18 significant risk factors, including being female (OR = 2.23, 95% CI: 1.89–2.63), advanced age (MD = 1.35, 95% CI: 0.04–2.66), obesity (OR = 1.21, 95% CI: 1.11–1.31), catheterization (OR = 3.8, 95% CI: 2.29–6.32), blood transfusion (OR = 1.39, 95% CI: 1.21–1.58), American Society of Anesthesiologists ≥III (OR = 1.28, 95% CI: 1.18–1.40), general anesthesia (OR = 1.26, 95% CI: 1.11–1.43), intertrochanteric fracture (OR = 1.25, 95% CI: 1.01–1.54), hemiarthroplasty (OR = 1.43, 95% CI: 1.19–1.69), prolonged length of hospital stay (MD = 1.44, 95% CI: 0.66–2.23), delirium (OR = 2.66, 95% CI: 2.05–3.47), dementia (OR = 1.82, 95% CI: 1.62–2.06), Parkinson's disease (OR = 1.53, 95% CI: 1.46–1.61), diabetes (OR = 1.27, 95% CI: 1.13–1.43), hypertension (OR = 1.14, 95% CI: 1.03–1.26), congestive heart failure (OR = 1.35, 95% CI: 1.10–1.66), history of sepsis (OR = 7.13, 95% CI: 5.51–9.22), and chronic steroid use (OR = 1.29, 95% CI: 1.06–1.57).ConclusionOur study identifies numerous risk factors strongly associated with UTI, offering compelling evidence and actionable strategies for improving clinical prediction, enabling early intervention, and facilitating targeted UTI management.Systematic review registrationidentifier [CRD42023459600], https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=459600.

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Incidence, risk factors and clinical implications of postoperative urinary tract infection in geriatric hip fractures

Cited by 10 publications

References 20 publications

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

Predicting risk factors for postoperative pneumonia in patients with lower limb fractures based on logistic regression model

Risk factors for urinary tract infection in geriatric hip fracture patients: a systematic review and meta-analysis

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