Risk factors for septic shock in older patients with urinary tract infection.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2024-11-25 DOI:10.1007/s10157-024-02563-x

Takaaki Tsuchiya, Kenta Taito, Yui Ota, Shiho Matsuno, Noriko Yamanaka, Masatoshi Oka, Noriyuki Suzuki, Mitsuyo Itabashi, Takashi Takei

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引用次数: 0

Abstract

Backgrounds: Few studies have addressed the risk factors for the development of septic shock in older patients with urinary tract infections. We decided to investigate whether a similar risk exists in in older patients.

Methods: A total of 1478 older patients (492 men, 986 women) aged 65 years or older (mean age 85.1 years) who were hospitalized and treated for urinary tract infections were included in this study, and factors contributing to the development of septic shock in these patients, including in terms of the causative pathogens and treatments employed, were investigated through a retrospective review of the patients' medical charts.

Results: Underlying urinary tract infection with urolithiasis was found as the most significant risk factor for the development of septic shock (p < 0.01). Patients with urolithiasis were more frail, had higher urinary pH and calcium levels, and showed a higher frequency of infections caused by antimicrobial-resistant and rare bacteria. Cluster analysis revealed a higher incidence of death, septic shock, urolithiasis, and frailty in the patient group treated with carbapenem and/or MRSA agents.

Conclusion: Septic shock was associated with a high risk of death in older patients with urinary tract infections, and urolithiasis was identified as an independent risk factor for the development of septic shock. Urolithiasis was also associated with frailty, suggesting that prevention of frailty may indirectly improve the prognosis of patients with septic shock secondary to urinary tract infections.

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老年尿路感染患者出现脓毒性休克的风险因素。

背景：很少有研究探讨老年尿路感染患者发生脓毒性休克的风险因素。我们决定调查老年患者是否存在类似风险：本研究共纳入了 1478 名 65 岁或 65 岁以上（平均年龄 85.1 岁）因尿路感染住院治疗的老年患者（男性 492 人，女性 986 人），并通过回顾性审查患者的病历调查了导致这些患者发生脓毒性休克的因素，包括致病病原体和采用的治疗方法：结果：尿路感染合并尿路结石是导致脓毒性休克的最重要的风险因素（p 结论：脓毒性休克的发病率较高：脓毒性休克与老年尿路感染患者的高死亡风险相关，而尿路结石被认为是脓毒性休克发生的独立风险因素。尿路结石还与体弱有关，这表明预防体弱可能会间接改善尿路感染继发脓毒性休克患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.