復健病房腦中風病人泌尿道感染之危險因子

The Risk Factors of Urinary Tract Infection in Stroke Patients in Rehabilitation Wards

目的：本研究探討腦中風病人於復健病房之泌尿道感染相關危險因子。方法：病例回溯2011年3月至2012年3月間，於復健病房住院期間接受腦中風復健治療的病人，共收案136位，調查泌尿道感染之發生率及可能危險因子。結果：腦中風病人在復健病房住院期間之泌尿道感染發生率為15.4%。年齡愈大（OR=1.07, 95%CI=1.02-1.12, p=0.007）、置放導尿管（OR=4.99, 95%CI=1.17-21, p=0.030）、巴氏量表分數愈低（OR=0.97, 95%CI=0.94-0.99, p=0.031）為泌尿道感染之危險因子。結論：年齡愈大，置放導尿管，巴氏量表分數愈低會顯著增加泌尿道感染風險。早期評估及處理排尿障礙以減少置放導尿管之機率，早期接受腦中風復健治療以增進日常生活自理能力，以期減少復健病房腦中風病人之泌尿道感染。

Objectives. The purpose of this study was to investigate the risk factors of urinary tract infection in stroke patients in rehabilitation wards. Methods. The medical records of 136 patients receiving rehabilitation therapies from March 2011 to March 2012 were retrospectively reviewed. We collected data on the frequency of urinary tract infection and identified possible risk factors. Results. The frequency of urinary tract infection in rehabilitation wards was 15.4%. The independent risk factors were age (OR=l.07, 95% CI=l.02-1.12, p=0.007), Foley catheter use (OR=4.99, 95% CI=1.17-21.37, p=0.030), and the Barthel index (OR=0.97, 95% CI=0.94 - 0.99, p=0.031). Conclusion. Old age, Foley catheter use, and low Barthel index scores significantly increased the risk of urioary tract infection. Early evaluation and treatment of urinary dysfunction, the elimination of Foley catheter use, and early physical rehabilitation for better daily living activities can help reduce the frequency of urinary tract infection in stroke patients in rehabilitation wards.