Correlation Between Bladder Debris and Abnormal Urinalysis: Health Warnings and Research Prospects in Elderly Patients

ABSTRACT Background Ultrasound‐detected bladder debris is hypothesized to reflect urinary tract inflammation or infection, yet its clinical significance in older adults, a population with high asymptomatic urinary tract infections (UTI) rates and diagnostic challenges, remains poorly characterized. This study examined the association between debris severity and urinalysis abnormalities in elderly patients. Methods A retrospective cohort study enrolled 336 community‐dwelling adults aged ≥ 65 years (excluding bladder stones, catheters, or anuria) who underwent standardized ultrasonography and urinalysis at a tertiary center (January–October 2024). Debris was graded (0–3) by two sonographers. Urinalysis parameters (leukocytes, erythrocytes, nitrite, and protein) were analyzed via chi‐square tests, Spearman correlation, and multinomial logistic regression adjusted for age, gender, and UTI history. Results Debris was detected in 240 patients (71.4%), with higher prevalence in females (82.5% vs. 63.2%, p = 0.001). Debris severity strongly correlated with leukocyturia (Spearman r = 0.87, p < 0.001), nitrite positivity (Cramér's V = 0.34, p < 0.001), erythrocyturia ( r = 0.24, p = 0.01), and proteinuria (V = 0.12, p = 0.009). Multivariate analysis identified leukocyturia (OR = 18.70, 95% CI: 8.12–43.15) and erythrocyturia (OR = 1.95, 95% CI: 1.12–3.40) as independent predictors of moderate–severe debris. Conclusion Bladder debris in older adults strongly associates with urinary infection and inflammation markers, particularly in women. Routine ultrasonographic debris grading may enhance early detection of subclinical UTIs, potentially aiding risk‐stratified management of subclinical urinary abnormalities in this high‐risk population.