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

Patcharee Aueaananratthakit; Kamontip Harnphadungkit

Authors

Patcharee Aueaananratthakit Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University
Kamontip Harnphadungkit Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University https://orcid.org/0000-0003-3101-8804

Keywords:

prevalence, inpatients, rehabilitation, stroke, urinary tract infection

Abstract

Objectives: To investigate the prevalence, characteristics, associated 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 diagnosed 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 reduction 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 rehabilitation admission is associated with age and dysphagia, but not with UTI.

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