Diagnostic value of combined detection of blood inflammation and urine routine indicators for urinary tract infection in bedridden patients with consciousness disorders

Wang Zhiyuan; Li Zhifeng

doi:10.3969/j.issn.1674-7151.2024.02.008

Abstract：Objective To explore the diagnostic value of combined detection of blood inflammation and urine routine indicators for urinary tract infection(UTI)in bedridden patients with consciousness disorders.Methods The 42 patients bedridden with impaired consciousness and UTI admitted to Sihong Hospital from January 2019 to June 2023 were selected as research objects and included in UTI group.In addition,50 patients bedridden with impaired consciousness without UTI and 50 elderly patients were included in non-infection group and control group,respectively.The reaults of procalcitonin(PCT),systemic inflammatory response index(SIRI),C-reactive protein(CRP)to albumin(ALB)ratio(CRP/ALB)and the positive rates of urine nitrite(NIT)and urine leukocyte esterase(LEU)were collected from all patients,and the differences in above indexes were compared.The receiver operator characteristic(ROC)curve was plotted,the area under ROC curve(AUC)was calculated,and the diagnostic efficacy of each index in diagnosis of UTI in bedridden patients with impaired consciousness was analyzed.Results The levels of PCT,SIRI,CRP/ALB and the positive rates of urine NIT and urine LEU in UTI group were higher than those in non-infection group and control group[PCT(μg/L):2.32±1.24 vs.0.98±0.36,0.69±0.24;SIRI:6.08±1.36 vs.4.15±1.06,3.25±0.86;CRP/ALB:2.23±1.36 vs.1.68±0.65,1.23±0.21;positive rate of urine NIT:73.81%vs.12.00%,10.00%;positive rate of urine LEU:80.95%vs.10.00%,8.00%;all P<0.05].Among individual indicators,the AUC of urine LEU positive rate for diagnosis of UTI in bedridden patients with impaired consciousness was 0.726[95%confidence interval(95%CI)was 0.698-0.781],and the specificity was the highest(78.4%).The sensitivity of PCT was the highest(73.1%).The AUC of five indicators combination reached 0.896,with specificity of 87.9%,sensitivity of 90.2%and diagnostic accuracy of 91.30%.Conclusion The combination of urine routine and stable hematological indicators has high diagnostic value for UTI in bedridden patients with consciousness disorders.