Infection Risk of Urinary Collection Strategies

描述(由申请者提供)：每年有数百万美国人接受导尿术。导管相关性尿路感染(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，在具有全国代表性的美国人样本中，还没有前瞻性研究列举长期护理机构居民患尿路感染和败血症的风险。也没有对这种风险的决定因素和后果进行基于人群的研究。这项研究就是为了解决这些问题。这项研究的第一个目的是描述在长期护理机构的一组居民中使用尿液收集装置的情况，并确定这种使用的先行因素和影响。将利用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限度数据集。选定的州占美国老年人口的34.9%。第二个目标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的风险。还将确定因尿路感染和败血症而住院的比率。将进行一项以人群为基础的队列研究，使用包含来自长期护理最低数据集的信息的链接数据库和来自加利福尼亚州、德克萨斯州、纽约、佛罗里达州和密歇根州的急性护理医院的医疗保险数据，2002-2003年。最小数据集包含有关每个患者的身体功能、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、心理社会健康状况和背景的信息，以便识别感染或住院风险较大的个人。这项调查将是第一次以人群为基础的研究，以确定美国长期护理机构中尿路感染和败血症风险较高的人的特征。这将为监测目的、预防工作和卫生保健规划提供有价值的基线信息。由于大约40%的美国老年人会在某个时候进入养老院，识别那些有感染风险的人可能会产生相当大的健康、生活质量和经济后果。

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.