Bacteriuria and mortality in an elderly population

Area of Science:

• Geriatrics
• Infectious Diseases
• Epidemiology

Background:

• Bacteriuria in elderly populations is associated with increased mortality.
• The cause of this increased mortality (bacteriuria itself vs. comorbidities) remains unclear.

Purpose of the Study:

• To investigate the association between bacteriuria and mortality in an elderly Swedish population.
• To determine if bacteriuria or associated conditions contribute to increased mortality in older adults.

Main Methods:

• Screening of 1966 elderly individuals (mean age 70) in Göteborg, Sweden, for bacteriuria.
• Analysis of five- and nine-year mortality rates in bacteriuric versus non-bacteriuric individuals.
• Subgroup analysis excluding women with indwelling catheters and men with cancer.

Main Results:

• Five-year mortality was higher in bacteriuric women (13.4%) vs. non-bacteriuric (9.4%), but not significant at nine years.
• Excluding catheterized women eliminated the mortality difference.
• Bacteriuric men had higher cancer rates (27.3% vs. 5.8%) and mortality; however, bacteriuric men without cancer showed no increased mortality.

Conclusions:

• The increased mortality observed in elderly patients with bacteriuria is likely attributable to associated fatal diseases, not bacteriuria per se.
• Underlying comorbidities, particularly cancer in men, play a significant role in the mortality risk associated with bacteriuria.
• Catheter use confounds the association between bacteriuria and mortality in elderly women.