Predictors of Urinary Tract Infection in Acute Stroke Patients: A Case Control Study

Abstract

Background Patients with stroke have a high risk of infection which may be predicted by methods. The methods can reduce unfavourable outcome by preventing the occurrence of infection. Therefore, we aim to identify early predictors for urinary tract infection in patients after stroke. Methods In 186 collected acute stroke patients, we divided them into urinary tract infection group, other infection type groups, and non-infected group. Data were recorded at admission. Independent risk factors and infection prediction model were determined using Logistic regression analyses. Likelihood ratio test was used to detect the prediction effect of the model. Receiver Operating Characteristic curve and the corresponding area under the curve were used to measure the predictive accuracy of indicators for urinary tract infection. Results Of the 186 subjects, there were 35 cases of urinary tract infection. Elevated interleukin-6, higher NIHSS, and decreased hemoglobin may be used to predict urinary tract infection. And, the predictive model for urinary tract infection (including sex, NIHSS, interleukin-6, and hemoglobin) have the best predictive effect. Conclusion This study is the first to discover decreased hemoglobin which may predict urinary tract infection. The prediction model shows the best accuracy.

Determinants of urinary tract infection in hospitalized patients with acute ischemic stroke

“…Consistent with data reported by Li et al in 2020, a higher NIHSS score was associated with UTI. Additionally, in 2022, Mukapa et al found that an NIHSS score of 16-42 is a risk for UTI (OR 5.15, 95% CI 1.68-15.75; p < 0.001) [15,16]. Therefore, stroke severity, as evaluated using the NIHSS on admission, appears to be associated with the incidence of UTI.…”

“…Although stroke severity itself may increase the risk of UTI [15,16] and could explain some of the associations between UTIs and poorer outcomes, a causal effect of UTI on stroke recovery is also possible and may be multifactorial. It is well documented that fever in patients with brain injury of any etiology, including stroke, correlates with poorer outcomes in many measures, including mortality, mRS score, BI, and hospital LOS [102].…”

“…UTIs are associated with poor outcomes [11], death, or disability [7,12]. Data from previous studies show that the female sex, previous stroke [13], urinary catheterization [14], a higher initial modified Rankin Scale (mRS) score, a higher initial National Institutes of Health Stroke Scale (NIHSS) score [15,16], older age [12], depressed consciousness, and diabetes mellitus [17] are associated with an increased incidence of infection, but there are many factors that have not been addressed, such as chronic kidney disease, the Barthel Index (BI), the Glasgow Coma Scale (GCS), vital signs, laboratory indicators, and stroke treatments. Therefore, we aimed to assess the determinant factors of UTIs and to explore the incidence, clinical features, and impact of UTIs on stroke outcomes in hospitalized patients with acute ischemic stroke (AIS).…”