Daily-Living Dependency a Risk Factor for UTI Hospitalization in Home-Care Patients

By Reuters Staff

NEW YORK (Reuters Health) - Activities of daily living (ADL) dependency is "a potentially modifiable risk factor" for hospitalization for urinary tract infection (UTI) in older people receiving home healthcare (HHC), researchers say.

"ADL dependency levels can inform clinical interventions to ameliorate ADL dependency in HHC settings and identify groups of patients at high risk for UTI-related hospitalization," Dr. Zainab Toteh Osakwe of Adelphi University College of Nursing and Public Health in Garden City, New York, and colleagues write in the American Journal of Infection Control, online February 14.

Among skilled nursing facility (SNF) residents, ADL dependency is associated with hospitalization for UTI, while improvement of walking ability can reduce UTI hospitalization risk, the authors note.

To investigate whether ADL status might also be associated with UTI hospitalization in HHC patients, the authors analyzed data from the Outcome and Assessment Information Set on more than 24,000 HHC patients 65 and older hospitalized in 2013.

The 1,133 patients hospitalized for UTI-related causes had significantly worse ADL dependency, more impaired decision making and lower Charlson Comorbidity Index score than those hospitalized for other causes.

Factors significantly associated with UTI-related hospitalization included female sex (adjusted odds ratio, 1.44), Medicaid coverage (aOR 1.99), severe ADL dependency (aOR, 1.50), having a caregiver to assist with supervision and safety (aOR, 1.24), UTI treatment in the previous two weeks (aOR, 2.85), having a urinary catheter (aOR, 3.77) and history of indwelling or suprapubic catheter (aOR, 1.44).

None of the patients hospitalized for UTI-related causes had a UTI diagnoses on admission to HHC, the authors note.

The Centers for Medicare and Medicaid Services classify UTIs developed during HHC and hospitalization during an episode of HHC as potentially avoidable events, the authors note.

"Registered nurses and physical therapists working in HHC settings can identify high-risk patients on admission to HHC who may benefit from monitoring and interventions to mitigate these risk factors earlier in the HHC episode," Dr. Osakwe and colleagues write.

"These findings highlight the importance of managing patients with the identified risk factors more closely in the HHC to prevent hospitalizations and reduce associated health care cost," they conclude.

SOURCE: https://bit.ly/2H6uGNV

Am J Infect Control 2019.

(c) Copyright Thomson Reuters 2019. Click For Restrictions - https://agency.reuters.com/en/copyright.html
Source: