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Table 3 Summary of Studies using Valid Criteria for Confusion

From: The scientific evidence for a potential link between confusion and urinary tract infection in the elderly is still confusing - a systematic literature review

Study Design of Study Patient Sample Number, Age, Female %, Catheter % Care Setting Association between Confusion and UTI Primary Aim of Study Confusion Diagnostic Criteria UTI/Bacteriuria Diagnostic Criteria Results
Boockvar et al. 2013 [54] Cohort; Prospective 136 patients Age: mean 76 years, SD 12 Female 40% Catheter: Unclear Nursing Home Partial Delirium CAM Bacteriuria Not Stated UTI Not described 11 out of 43 (26%) incidents of UTI had delirium
Collins et al. 2010 [60] Cross Sectional; Prospective 710 patients Age: ≥ 70 years; mean 83, range 70–101 Female: 60% Catheter: 5.5% Hospital (Medical Acute Admissions Unit) Partially Delirium CAM Bacteriuria Not Stated UTI ICD – 10 Codes 16 out of 110 (15%) patients admitted with delirium had UTI
Culp et al. 1997 [66] Cross Sectional; Prospective 37 residents Age: ≥65 years; Female: Unclear Catheter: Unclear Long term care facilities (intermediate and skilled bed) Partially Delirium screened using NEECHAM and confirmed with CAM Bacteriuria Not Stated UTI Defined by leukocyturia 7 out of 15 (47%) patients with delirium had UTI
Eriksson et al. 2011 [70] Cross Sectional; Prospective 504 citizens from population record, Age: 172 aged 85 years, 169 aged 90 years, 63 aged ≥95 years, Female: 100% Catheter: 1.8% Community Setting (Institutionalised care: 238/504) Yes Delirium Organic Brain Syndrome Scale Bacteriuria Not Stated UTI documented symptomatic UTI, with short- or long-term antibiotics, or symptoms and laboratory tests judged to indicate a UTI 39 out of 87 (45%) patients with UTI had delirium 39 out of 137 (29%) patients with delirium had UTI UTI was present in 29% of patients with delirium and 13% of those without delirium (p < 0.001) UTI was associated with delirium OR 1.9 (95% CI 1.1–3.3, p = 0.025)
George et al. 1997 [55] Case Controlled Prospective 171 delirious patients Age: ≥65 years mean 81, range 65–98 Female: 54% Catheter: Unclear Hospital Partial Delirium DSM III Criteria Bacteriuria Not Stated UTI Not Stated 25 out of 171 (15%) patients with delirium had UTI
Juthani-Mehta et al. 2009 [3] Cohort Study Prospective 551 Residents Age: ≥65 years mean 86, SD 7.1 Female:81% Catheter: 0% Long Term Care Facilities Partial Change in Mental Status Adapted delirium criteria from DSM VI Bacteriuria ≥104 cfu/ml on urine culture + pyuria (> 10 WBC) on urinalysis UTI Not Stated 70 out of 147 (48%) patients with bacteriuria + pyuria had mental status changes 70 out of 170 (41%) patients with mental status change had bacteriuria + pyuria Association of mental status change with bacteriuria +pyuria RR 1.4 (95% CI 1.0–1.7, p = 0.034)
Laurila et al. 2008 [71] Cohort Study Prospective 87 patients Age: ≥70 years mean 83.8, range 71–97 Female: 76% Catheter: Unclear Hospital (Medical Ward) Partial Delirium DSM-IV Bacteriuria Not Stated UTI Consensus of three geriatricians after assessment 35 of 87 (40%) patients with delirium had UTI
Marcantonio et al. 2005 [72] Cohort; Prospective 188 patients with delirium Age: ≥ 65 years mean 83.3, SD 7.4 Female: 68% Catheter: Unclear Hospital (Post-acute admissions) No Delirium CAM Bacteriuria Not Stated UTI Clinically documented in the medical record 22 out of 188 (12%) patients with delirium had UTI 12% of patients with delirium had UTI compared to 7% of patients without delirium (p = 0.22)