Rev Esp Quimioter 2025; 38(1): 28-39
Epidemiological and clinical management aspects related to urinary tract infections diagnosed in the emergency department in elderly patients in Spain: Results of the EDEN-36 study
OCTAVIO JOSÉ SALMERÓN BÉLIZ, ELIA PÉREZ-FERNÁNDEZ, ÒSCAR MIRÓ, SIRA AGUILÓ, GUILLERMO BURILLO-PUTZE, AITOR ALQUÉZAR-ARBÉ, CESÁREO FERNÁNDEZ-ALONSO, JAVIER JACOB, FRANCISCO JAVIER MONTERO PÉREZ, ALEJANDRO MELCON VILLALIBRE, SANDRA CUERPO CARDEÑOSA, LETICIA SERRANO LÁZARO, MARÍA CABALLERO MARTÍNEZ, ESTHER MUÑOZ SOLER, INMACULADA BAJO FERNÁNDEZ, ANA ISABEL CASTUERA GIL, ROCÍO HERNANDO GONZÁLEZ, ALBERT CARBÓ-JORDÁ, IRENE CABRERA RODRIGO, BELÉN GROS BAÑERES, CARLOS ROMERO CARRETE, RAFAELA RÍOS GALLARDO, ALEJANDRO CORTÉS SOLER, EMMA GONZÁLEZ NESPEREIRA, ÁNGEL GARCÍA GARCÍA, JOSÉ RAMÓN OLIVA RAMOS, LUCIA HINOJOSA DIAZ, JUAN GONZÁLEZ DEL CASTILLO, EN NOMBRE DE LOS INVESTIGADORES DE LA RED SPANISH INVESTIGATORS IN EMERGENCY SITUATIONS TEAM (SIESTA)
Published: 14 November 2024
http://www.doi.org/10.37201/req/066.2024
Objective. To estimate the incidence of urinary tract infections (UTI) in elderly patients in Spanish emergency departments (ED), the need for hospitalization, diagnostic confirmation in hospitalized patients, adverse events and the predictive capacity of several biomarkers.
Methods. In this a posteriori substudy of a generic study of reasons for ED visits in elderly patients, we included patients aged ≥65 years seen in 52 Spanish EDs for 1 week, selecting those diagnosed with UTI. As adverse events, in-hospital and 30-day mortality and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Relative risks (RR) were calculated. The predictive capacity of 10 variables and 6 biomarkers was investigated.
Results. A total of 25,375 patients were included, 1058 with UTI (annual incidence: 24.7 per 1000 inhabitants aged ≥65 years and year, 95%CI: 24.5-24.9). A total of 36.5% were hospitalized, and in 80% the diagnosis of UTI was confirmed at discharge. Overall 30-day mortality was 5.4% and in-hospital mortality was 3.4%. Functional dependence was associated with both events (RR:2.91;1.18-7.17 and RR:12.61;1.47-108.11, respectively), as was having a CRP greater than 100 mg/L (RR:2.24;1.17-4.30 and RR:3.21;1.37-7.51, respectively). The combined post-high event occurred in 10.6%, and was associated with functional dependence (RR:2.05;1.04-4.06). CRP and hemoglobin had significant value in predicting 30-day post-discharge mortality or hospitalization.
Conclusions. UTI is a frequent diagnosis in elderly patients consulting in the ED. Functional dependence is the best factor associated with adverse events. The biomarkers analyzed do not have a good predictive capacity.
Rev Esp Quimioter 2025; 38(1): 28-39 [Texto completo PDF]
