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Frailty and postoperative urinary tract infection
Susan A Tuddenham1, Susan L Gearhart2, E James Wright Iii3
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
BMC Geriatrics
|October 28, 2022
Summary
Frailty increases the risk of postoperative urinary tract infection (UTI) in older adults, independent of age. This finding highlights the need for targeted interventions to reduce UTI risk in frail patients.
Area of Science:
- Geriatric Medicine
- Surgical Outcomes
- Infectious Disease Epidemiology
Background:
- Postoperative urinary tract infection (UTI) poses significant risks for older adults, including higher readmission rates and mortality.
- While age is a known risk factor for UTI, the specific impact of frailty remains unclear.
- This study investigates frailty as an independent predictor of postoperative UTI in the elderly population.
Purpose of the Study:
- To determine if frailty is an independent risk factor for postoperative urinary tract infection (UTI) in older adults.
- To quantify the association between increasing frailty and the likelihood of developing a postoperative UTI.
- To control for age and other relevant patient and surgical factors in this analysis.
Main Methods:
- Utilized data from the U.S. National Surgical Quality Improvement Program (NSQIP) spanning 2014-2018.
- Assessed patient frailty using the modified Frailty Index.
- Employed logistic regression modeling to analyze the association between frailty and postoperative UTI, adjusting for confounders.
Main Results:
- Postoperative UTI occurred in 1.3% of 1,724,042 procedures.
- A significant, independent association was found between higher frailty scores and increased odds of postoperative UTI.
- Relative odds of UTI increased with frailty score, reaching 2.50 (95% CI 1.73, 3.61) for the maximum score.
Conclusions:
- Frailty is a significant, independent risk factor for postoperative urinary tract infection in older adults.
- These findings underscore the importance of considering frailty in risk assessment for surgical patients.
- Further research is warranted to explore mechanisms and develop mitigation strategies for frail individuals.
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