Evidence map›Paper›PMID 37487642›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2023

Hospital admission after primary care consultation for community-onset lower urinary tract infection: a cohort study of risks and predictors using linked data.

Anna Aryee, Patrick Rockenschaub, John Robson, Marian Priebe, Zaheer Ahmed, Caoimhe Nic Fhogartaigh, David Ball, Andrew Hayward, Laura Shallcross

Open access · hybridAbstract read
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In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Anna AryeeInstitute of Health Informatics, University College London, London.ORCID 0000-0001-9537-8011
Patrick RockenschaubInstitute of Health Informatics, University College London, London.ORCID 0000-0002-6499-7933
John RobsonClinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London.ORCID 0000-0001-6889-0415
Marian PriebeClinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London.ORCID 0000-0003-0732-8167
Zaheer AhmedClinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London.
Caoimhe Nic FhogartaighBarts Health NHS Trust, London.
David BallBarts Health NHS Trust, London.
Andrew HaywardInstitute of Epidemiology and Health Care, University College London, London.ORCID 0000-0002-3549-6232
Laura ShallcrossInstitute of Health Informatics, University College London, London.ORCID 0000-0003-1713-2555
University College London · GBQueen Mary University of London · GBBarts Health NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUrinary tract infections (UTIs) are a common indication for antibiotic prescriptions, reductions in which would reduce antimicrobial resistance (AMR). Risk stratification of patients allows reductions to be made safely.

aimTo identify risk factors for hospital admission following UTI, to inform targeted antibiotic stewardship. DESIGN AND

settingRetrospective cohort study of East London primary care patients.

methodHospital admission outcomes following primary care consultation for UTI were analysed using linked data from primary care, secondary care, and microbiology, from 1 April 2012 to 31 March 2017. The outcomes analysed were urinary infection-related hospital admission (UHA) and all-cause hospital admission (AHA) within 30 days of UTI in primary care. Odds ratios between specific variables (demographic characteristics, prior antibiotic exposure, and comorbidities) and the outcomes were predicted using generalised estimating equations, and fitted to a final multivariable model including all variables with a

resultsOf the 169 524 episodes of UTI, UHA occurred in 1336 cases (0.8%, 95% confidence interval [CI] = 0.7 to 0.8) and AHA in 6516 cases (3.8%, 95% CI = 3.8 to 3.9). On multivariable analysis, increased odds of UHA were seen in patients aged 55-74 years (adjusted odds ratio [AOR] 1.49) and ≥75 years (AOR 3.24), relative to adults aged 16-34 years. Increased odds of UHA were also associated with chronic kidney disease (CKD; AOR 1.55), urinary catheters (AOR 2.01), prior antibiotics (AOR 1.38 for ≥3 courses), recurrent UTI (AOR 1.33), faecal incontinence (FI; AOR 1.47), and diabetes mellitus (DM; AOR 1.37).

conclusionUrinary infection-related hospital admission after primary care consultation for community-onset lower UTI was rare; however, increased odds for UHA were observed for some patient groups. Efforts to reduce antibiotic prescribing for suspected UTI should focus on patients aged <55 years without risk factors for complicated UTI, recurrent UTI, DM, or FI.

Indexed as

Renal Insufficiency, ChronicUrinary Tract InfectionsAdultAnti-Bacterial AgentsCohort StudiesHospitalsHumansPrimary Health CareReferral and ConsultationRetrospective StudiesSemantic WebAnti-Bacterial Agentsantimicrobial stewardshipcohort studiesprimary caresecondary careurinary tract infections

Identifiers

PMID37487642
PMCPMC10394611
OpenAlexW4367680463

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.