Monday, October 6, 2025

Prevalence, Characteristics, and Impacts of Urinary Tract Infection on Functional Outcomes: A Retrospective Study of Inpatient Stroke Rehabilitation at Siriraj Hospital, Thailand

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 Prevalence, Characteristics, and Impacts of Urinary Tract Infection on Functional Outcomes: A Retrospective Study of Inpatient Stroke Rehabilitation at Siriraj Hospital, Thailand

 Patcharee Aueaananratthakit and Kamontip Harnphadungkit Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand iD 


 ABSTRACT 

 Objectives: 

To investigate the prevalence, characteristics, asso- ciated factors, and impacts of urinary tract infections (UTI) on the Barthel Index (BI) during inpatient stroke rehabilitation. Study design: 
Retrospective study Setting: 
Inpatient Rehabilitation Unit, Department of Rehabilitation Medicine, Siriraj Hospital, Bangkok, Thailand Subjects: 
Inpatients with stroke, aged ≥ 18 years old, admitted to the Rehabilitation Ward, Siriraj Hospital during 2019-2021 
 Methods: 
Demographic, clinical, and functional data of eligible patients were retrieved from the rehabilitation admission medical records in the hospital information system. 
 Results: 
Of 399 stroke patients identified, 11.5% had been diag nosed with UTI. Of these, 30.4% had catheter-associated UTIs (CAUTIs), while 69.6% had non-CAUTIs. Escherichia coli was identified as the most common pathogen. UTI was significantly associated with advanced age (p < 0.001), indwelling catheter use (p < 0.001), recurrent stroke (p = 0.031), and dysphagia (p < 0.019). Patients with UTI exhibited a statistically significant re duction in BI normalized gain per 21-day length of stay (BIg21days) (p = 0.033) and experienced longer rehabilitation length of stay (LOS) (p = 0.002). Using forward stepwise linear regression, only age and dysphagia, but not UTI, were found to be statistically significantly associated with BIg21days. 
 Conclusions: 
The prevalence of UTI is 11.5%, with higher rates in older individuals, those with recurrent stroke, dysphagia, and those using urinary catheters. Functional gain per 21 days of re habilitation admission is associated with age and dysphagia, but not with UTI. 
 Keywords: prevalence, inpatients, rehabilitation, stroke, urinary tract infection ASEAN J Rehabil Med. 2025; 35(3): 131-136. 

 Introduction 

  Stroke is a common health problem worldwide, including in Thailand.1 The prevalence of stroke is increasing, particularly among individuals over 45 years old. The mean age of stroke onset is 65 years.2 Although acute stroke treatment has advanced and improved, stroke survivors still face impair ments and disabilities. Intensive rehabilitation programs are an important component of management to reduce impairments and disabilities in stroke patients and can also improve their quality of life.3 Urinary tract infection (UTI) is one of the most frequent infectious complications encountered in post-stroke patients.4,5 Its prevalence varies, ranging from 3.7% to 19.0% in hospitalized stroke patients.4,6-9 Many factors contribute to UTI, including the retention of indwelling catheters. Studies have suggested a link between indwelling catheters and poor clinical outcomes after stroke.7 UTI is also associated with poor stroke outcomes, such as increased mortality, longer length of stay (LOS), and poorer functional outcomes as measured by the Barthel Index (BI).10 Nevertheless, several factors may affect the BI in post-stroke patients admitted for intensive rehabilitation, including age, previous stroke history, dysphagia, and admis sion functional level.11 However, no prior studies have examined the prevalence of UTI during inpatient stroke rehabilitation at Siriraj Hospital. Therefore, this study aimed to determine the prevalence of UTI, their characteristics, and related factors, as well as to assess their impacts on functional outcomes during inpatient stroke rehabilitation at Siriraj Hospital. These findings are expected to enhance the prevention and management of UTI during stroke rehabilitation. This study was reported according to the STROBE guidelines for observational studies

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