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The relationship between admission hyperglycaemia and urinary tract infections in geriatric patients with hip fractures

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Abstract

Purpose

This study investigated the association of admission hyperglycaemia with catheter-associated urinary tract infections (CAUTIs) and catheter-unassociated urinary tract infections (CUUTIs) in elderly patients with hip fractures.

Methods

In an observational cohort study of elderly patients with hip fractures, glucose values were collected within 24 h of admission. Urinary tract infections were classified as CAUTIs and CUUTIs. Multivariate logistic regression analysis and propensity score matching obtained adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for urinary tract infections. Subgroup analyses were further explored to investigate the relationship between admission hyperglycemia and urinary tract infections.

Results

The study included 1279 elderly patients with hip fractures, 298 (23.3%) of whom had urinary tract infections upon hospitalization (including 182 CAUTIs and 116 CUUTIs). Propensity score matching indicated that patients with glucose levels exceeding 10.00 mmol/L had significantly higher odds of developing CAUTIs (OR 3.10, 95% CI 1.65–5.82) than those with glucose levels between 4.00–6.09 mmol/L. It is worth noting that patients with blood glucose levels greater than 10.00 mmol/L have a higher susceptibility for CUUTIs (OR 4.42, 95% CI 2.09–9.33) than CAUTIs. The subgroup analyses observed significant interactions between diabetes and CAUTIs (p for interaction = 0.01) and between bedridden time and CUUTIs (p for interaction = 0.04).

Conclusions

Elderly hip fracture patients with admission hyperglycaemia have an independent association with CAUTIs and CUUTIs. The association is stronger with CUUTIs and necessitates clinician intervention if blood glucose levels at admission exceed 10 mmol/L.

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Acknowledgements

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Author notes

  1. Wei Yao and Wanyun Tang have made the same contribution to this work and are co-authors.

Authors and Affiliations

  1. Department of Orthopedics, Dandong Central Hospital, China Medical University, No. 338 Jinshan Street, Zhenxing District, 118002, Dandong, Liaoning Province, China

    Wei Yao, Wanyun Tang, Wei Wang & Wenbo Ding

  2. Department of Oncology, Dandong Central Hospital, China Medical University, No. 338 Jinshan Street, Zhenxing District, 118002, Dandong, Liaoning Province, China

    Qiaomei Lv

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  1. Wei Yao
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Contributions

Study concept: DWB and QML. Study design: All authors. Acquisition, analysis, or interpretation of data: WY, WYT, WW, and QML. Statistical analysis: WY and WYT. Drafting of the manuscript: WY and WYT. Critical revision of the manuscript for important intellectual content: All authors.

Corresponding author

Correspondence to Wenbo Ding.

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Ethics approval

This study was approved by the Ethics Committee of Dandong Central Hospital (No. DDZX-20230201) and conducted by the ethical principles outlined in the Helsinki Declaration of 1964 and its subsequent amendments. The ethics committee sought and obtained A waiver of consent for this cohort study.

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All the data used and analyzed during the current study are available from the corresponding author upon reasonable request.

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All authors state that they have no competing interests.

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Yao, W., Tang, W., Wang, W. et al. The relationship between admission hyperglycaemia and urinary tract infections in geriatric patients with hip fractures. International Orthopaedics (SICOT) 47, 2591–2600 (2023). https://doi.org/10.1007/s00264-023-05882-y

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