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Bacteriuria and mortality in an elderly population.

G R Nordenstam, C A Brandberg, A S Odén

    The New England Journal of Medicine
    |May 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

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    Bacteriuria in the elderly is linked to higher mortality, but this study suggests underlying diseases, not bacteriuria itself, are the cause. Excluding catheterized women showed no difference in mortality, indicating associated conditions are key factors.

    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.

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    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.