Risk of adverse outcomes following urinary tract infection in older people with renal impairment: Retrospective cohort study using linked health record data

Haroon Ahmed; Daniel Farewell; Nick A. Francis; Shantini Paranjothy; Christopher C. Butler

doi:10.1371/journal.pmed.1002652

Risk of adverse outcomes following urinary tract infection in older people with renal impairment: Retrospective cohort study using linked health record data

Haroon Ahmed^* (Corresponding Author), Daniel Farewell, Nick A. Francis, Shantini Paranjothy, Christopher C. Butler

^*Corresponding author for this work

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Abstract

Background Few studies have investigated the risk of adverse outcomes in older people with renal impairment presenting to primary care with a urinary tract infection (UTI). The aim of this study was to determine the risk of adverse outcomes in patients aged ?65 years presenting to primary care with a UTI, by estimated glomerular filtration rate (eGFR) and empirical prescription of nitrofurantoin versus trimethoprim. Methods and Findings This was a retrospective cohort study using linked health record data from 795,484 patients from 393 general practices in England, who were aged ?65 years between 2010 and 2016. Patients were entered into the cohort if they presented with a UTI and had a creatinine measurement in the 24 months prior to presentation. We calculated an eGFR to estimate risk of adverse outcomes by renal function, and propensity-score matched patients with eGFRs 60mls/min/1.73m2, patients with an eGFR of 60mls/min/1.73m2, patients with an eGFR of

Original language	English
Article number	1002652
Number of pages	16
Journal	PLoS Medicine
Volume	15
Issue number	9
Early online date	10 Sept 2018
DOIs	https://doi.org/10.1371/journal.pmed.1002652
Publication status	Published - 10 Sept 2018

Bibliographical note

Funding: This report is independent research arising from a National Institute of Health Research (NIHR) Doctoral Research Fellowship awarded to HA, and supported by Health and Care Research Wales (HCRW) (grant number DRF-2014-07-010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data Availability: Data analysed for this study were obtained under institutional license from the Clinical Practice Research Datalink, https://www.cprd.com/intro.asp. Data are not available for sharing but can be applied for through the CPRD. Relevant information to allow acquisition of a replicable data set is available in the paper and its Supporting Information files.

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Copyright: © 2018 Ahmed et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. https://creativecommons.org/licenses/by/4.0/
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Cite this

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title = "Risk of adverse outcomes following urinary tract infection in older people with renal impairment: Retrospective cohort study using linked health record data",

abstract = "Background Few studies have investigated the risk of adverse outcomes in older people with renal impairment presenting to primary care with a urinary tract infection (UTI). The aim of this study was to determine the risk of adverse outcomes in patients aged ?65 years presenting to primary care with a UTI, by estimated glomerular filtration rate (eGFR) and empirical prescription of nitrofurantoin versus trimethoprim. Methods and Findings This was a retrospective cohort study using linked health record data from 795,484 patients from 393 general practices in England, who were aged ?65 years between 2010 and 2016. Patients were entered into the cohort if they presented with a UTI and had a creatinine measurement in the 24 months prior to presentation. We calculated an eGFR to estimate risk of adverse outcomes by renal function, and propensity-score matched patients with eGFRs 60mls/min/1.73m2, patients with an eGFR of 60mls/min/1.73m2, patients with an eGFR of ",

author = "Haroon Ahmed and Daniel Farewell and Francis, {Nick A.} and Shantini Paranjothy and Butler, {Christopher C.}",

note = "Funding: This report is independent research arising from a National Institute of Health Research (NIHR) Doctoral Research Fellowship awarded to HA, and supported by Health and Care Research Wales (HCRW) (grant number DRF-2014-07-010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability: Data analysed for this study were obtained under institutional license from the Clinical Practice Research Datalink, https://www.cprd.com/intro.asp. Data are not available for sharing but can be applied for through the CPRD. Relevant information to allow acquisition of a replicable data set is available in the paper and its Supporting Information files. ",

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N1 - Funding: This report is independent research arising from a National Institute of Health Research (NIHR) Doctoral Research Fellowship awarded to HA, and supported by Health and Care Research Wales (HCRW) (grant number DRF-2014-07-010). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability: Data analysed for this study were obtained under institutional license from the Clinical Practice Research Datalink, https://www.cprd.com/intro.asp. Data are not available for sharing but can be applied for through the CPRD. Relevant information to allow acquisition of a replicable data set is available in the paper and its Supporting Information files.

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N2 - Background Few studies have investigated the risk of adverse outcomes in older people with renal impairment presenting to primary care with a urinary tract infection (UTI). The aim of this study was to determine the risk of adverse outcomes in patients aged ?65 years presenting to primary care with a UTI, by estimated glomerular filtration rate (eGFR) and empirical prescription of nitrofurantoin versus trimethoprim. Methods and Findings This was a retrospective cohort study using linked health record data from 795,484 patients from 393 general practices in England, who were aged ?65 years between 2010 and 2016. Patients were entered into the cohort if they presented with a UTI and had a creatinine measurement in the 24 months prior to presentation. We calculated an eGFR to estimate risk of adverse outcomes by renal function, and propensity-score matched patients with eGFRs 60mls/min/1.73m2, patients with an eGFR of 60mls/min/1.73m2, patients with an eGFR of

AB - Background Few studies have investigated the risk of adverse outcomes in older people with renal impairment presenting to primary care with a urinary tract infection (UTI). The aim of this study was to determine the risk of adverse outcomes in patients aged ?65 years presenting to primary care with a UTI, by estimated glomerular filtration rate (eGFR) and empirical prescription of nitrofurantoin versus trimethoprim. Methods and Findings This was a retrospective cohort study using linked health record data from 795,484 patients from 393 general practices in England, who were aged ?65 years between 2010 and 2016. Patients were entered into the cohort if they presented with a UTI and had a creatinine measurement in the 24 months prior to presentation. We calculated an eGFR to estimate risk of adverse outcomes by renal function, and propensity-score matched patients with eGFRs 60mls/min/1.73m2, patients with an eGFR of 60mls/min/1.73m2, patients with an eGFR of

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Risk of adverse outcomes following urinary tract infection in older people with renal impairment: Retrospective cohort study using linked health record data

Abstract

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