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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
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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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