Infection Risk of Urinary Collection Strategies

描述（由申请人提供）：每年有数百万美国人接受导尿。导尿管相关性尿路感染（DTI）是长期护理机构中最常见的感染，也是败血症的常见来源，每10名患者中就有2人死亡。然而，目前还没有一项具有全国代表性的美国人样本的前瞻性研究，列举了长期护理机构居民的尿路感染和败血症的风险。也没有针对这种风险的决定因素和后果的以人群为基础的研究。本研究旨在解决这些问题。本研究的第一个目的是描述在长期护理机构的一组居民中尿液收集装置的使用情况，并确定这种使用的前因和影响。将使用2002-2003年加利福尼亚州、德克萨斯州、纽约州、佛罗里达州和密歇根州的长期护理最低数据集。所选的州占美国老年人口的34.9%。第二个目的是通过长期护理机构居民的膀胱管理策略来确定尿路感染和败血症的发生和复发风险。还将确定尿路感染和败血症的住院率。将进行一项基于人群的队列研究，使用包含2002-2003年来自加利福尼亚州、德克萨斯州、纽约州、佛罗里达州和密歇根州急症护理医院的长期护理最低数据集和医疗保险数据的关联数据库。最低数据集包含关于每个病人的身体功能、健康状况、医疗诊断、日常生活活动、认知、感觉和交流模式、行为、饮食、活动模式、社会心理健康和背景的信息，以便能够确定感染或住院风险较大的个人。这项调查将是第一个以人群为基础的研究，以表征美国长期护理机构中尿路感染和败血症风险较高的个体。这将为监测目的、预防工作和卫生保健规划提供宝贵的基线信息。由于大约40%的美国老年人将在某个时候进入养老院，因此识别那些有感染风险的人可能会对健康、生活质量和经济后果产生相当大的影响。

DESCRIPTION (provided by applicant): Millions of Americans undergo urinary catheterization annually. Catheter-related urinary tract infection (DTI) is the most common infection seen in long-term care facilities and a common source of septicemia, which results in death for 2 of every 10 patients. Yet there are no prospective studies in a nationally representative sample of Americans that enumerate the risk of UTI and septicemia in residents of long-term care facilities. Nor are there population-based studies of the determinants and consequences of such risk. This study was designed to address these issues. The first aim of this study is to describe use of urinary collection devices in a cohort of residents in long-term care facilities and determine the antecedent factors and effects of such use. The Long Term Care Minimum Data Set for California, Texas, New York, Florida, and Michigan, years 2002-2003, will be utilized. The selected states represent 34.9% of the elderly population in the United States. The second aim is to determine the risks, both incident and recurrent, of UTI and septicemia by bladder management strategy in residents of long-term care facilities. Hospitalization rates due to UTI and septicemia will also be ascertained. A population-based cohort study will be conducted, using linked databases containing information from the Long Term Care Minimum Data Set and Medicare data from acute care hospitals in California, Texas, New York, Florida, and Michigan, years 2002-2003. The Minimum Data Set has information on the physical functioning, health conditions, medical diagnoses, activities of daily living, cognition, sensory and communication patterns, behavior, diet, activity patterns, psychosocial wellbeing, and background of each patient, so that individuals at greater risk of infection or hospitalization can be identified. This investigation would be the first population-based study to characterize those individuals at higher risk of UTI and septicemia in long-term care facilities in the United States. This will provide valuable baseline information for surveillance purposes, preventive efforts, and health care planning. Since approximately 40% of elderly Americans will enter a nursing home at some point, identification of those at risk of infection could have considerable health, quality of life, and economic consequences.