Zhongguo quanke yixue (Jul 2023)
Meta-analysis of Risk Factors for Urinary Tract Infection in Neurogenic Bladder
Abstract
Background Urinary tract infection is the most common complication in patients with neurogenic bladder, which severely affects the treatment effect and quality of life of patients. Early identification of its related factors and delivery of targeted measures of prevention and intervention are of great significance to improve the prognosis of patients. Recent studies on influencing factors of urinary tract infection in neurogenic bladder are increasing but have controversial results, and there is a lack of relevant systematic reviews and support from evidence-based medicine. Objective To systematically assess the risk factors of urinary tract infection in neurogenic bladder. Methods Databases of PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang Data, CQVIP, and SinoMed were searched for literature on risk factors of urinary tract infection in patients with neurogenic bladder from inception to June 2022. The quality of the included literature was assessed using the Newcastle-Ottawa Scale (NOS) . RevMan 5.3 was used for meta-analysis. Results A total of 13 articles with 3 319 cases were included. The NOS score of the articles ranged from 6 to 8. Meta-analysis results showed that advanced age〔OR≥60=2.50, 95%CI (1.83, 3.41) , P<0.000 01; OR≥65=2.13, 95%CI (1.40, 3.25) , P=0.000 4〕, diabetes〔OR=3.17, 95%CI (2.58, 3.89) , P<0.000 01〕, hypoalbuminemia〔OR=2.26, 95%CI (1.67, 3.06) , P<0.000 01〕, number of strokes ≥2〔OR=3.30, 95%CI (1.70, 6.41) , P=0.000 4〕, indwelling catheter〔OR=2.88, 95%CI (2.09, 3.95) , P<0.000 01〕, frequency of intermittent catheterization ≥2 times/week〔OR=2.44, 95%CI (1.62, 3.68) , P<0.000 1〕, frequency of bladder irrigation≥3 times/week〔OR=2.63, 95%CI (1.66, 4.17) , P<0.000 1〕, duration of bladder function training intervention≥2 weeks〔OR=2.75, 95%CI (1.69, 4.46) , P<0.000 1〕, duration of rehabilitation intervention >7 d〔OR=3.03, 95%CI (1.42, 6.48) , P=0.004〕were associated with increased risk of urinary tract infection in neurogenic bladder; Male〔OR=0.78, 95%CI (0.63, 0.96) , P=0.02〕was associated with decreased risk of urinary tract infection in neurogenic bladder. Conclusion Older age, complicated with diabetes, hypoalbuminemia, number of strokes ≥2, indwelling catheter, frequency of intermittent catheterization ≥2 times/week, frequency of bladder irrigation ≥3 times/week, duration of bladder function training intervention ≥2 weeks, and duration of rehabilitation intervention >7 d may be the risk factors for urinary tract infection in neurogenic bladder. To prevent or reduce the risk of urinary tract infection in these patients, clinical workers should identify the aforementioned high-risk factors as early as possible, and provide the patients with interventions targeting the controllable factors.
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