Prediction of complicated urinary tract infections in patients with type 2 diabetes: a questionnaire study in primary care |
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Authors: | Leonie M A J Venmans Marian Sloof Eelko Hak Kees J Gorter Guy E H M Rutten |
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Institution: | (1) Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. 85500, 3508 6A Utrecht, The Netherlands |
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Abstract: | Background Relatively few data are available to predict a complicated course of community-acquired complicated urinary tract infections
(UTIs) in patients with diabetes type 2 (DM2). The aim of this study was to assess predictors for a complicated course of
UTIs in DM2 patients in primary care.
Method We conducted a cross-sectional questionnaire study among DM2 patients aged over 45 years as part of an educational trial.
The combined outcome measure was a complicated course of UTI, defined as a self-reported episode of acute pyelonephritis,
prostatitis or recurrent cystitis in the 12 months before the trial. Patients with an outcome were all verified by review
of medical records. A prediction model was derived with multivariable logistic regression analysis.
Results Of the 1151 trial participants, 94 (8%) had a self-reported community-acquired complicated course of UTIs and 62 (66%) of
these were medically-attended. Independent predictors for a complicated course were age above 60 years (adjusted odds ratio
(OR): 1.74; 95% confidence interval (CI): 0.99–3.03), chronic use of antibiotics (adjusted OR: 5.50; 95% CI: 2.31–13.08),
more than 6 physician contacts in previous year (adjusted OR: 3.60; 95% CI: 2.00–6.49), hospitalization in previous year (adjusted
OR: 1.36; 95% CI: 1.00–1.85), renal disease (adjusted OR: 4.92; 95% CI: 1.59–15.18) and incontinence of urine (adjusted OR:
3.78; 95% CI: 1.93–7.38). Area under the receiver-operating curve was 0.72 (95% CI: 0.66–0.78). Analysis according to medically
attended complicated UTIs did not change our findings.
Conclusion Easily obtainable predictors from medical history can be used to accurately predict a complicated course of UTIs in DM2 patients. |
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Keywords: | Diabetes Complicated course General practice Prognosis Urinary tract infection |
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