1056 INPATIENT UTI TRENDS AND PREDICTORS OF MORTALITY

Field: Medicine (Health Sciences)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder (I)1 Apr 20131056 INPATIENT UTI TRENDS AND PREDICTORS OF MORTALITY Al'a Abdo, Jesse Sammon, Florian Roghmann, Andreas Becker, Malek Meskawi, Zhe Tian, Hugo Lavigueur-Blouin, Pierre I Karakiewicz, Maxine Sun, and Quoc-Dien Trinh Al'a AbdoAl'a Abdo Montreal, Canada More articles by this author , Jesse SammonJesse Sammon Detroit, MI More articles by this author , Florian RoghmannFlorian Roghmann Herne, Germany More articles by this author , Andreas BeckerAndreas Becker Hamburg, Germany More articles by this author , Malek MeskawiMalek Meskawi Montreal, Canada More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Hugo Lavigueur-BlouinHugo Lavigueur-Blouin Montreal, Canada More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz Montreal, Canada More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.642AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract infections (UTIs) are a common medical condition and represent a significant contributor to health care expenditures. In this study, we examine the temporal trends in UTI incidence and mortality, and explore the predictors of mortality and increased length of stay (LOS) related to UTI in the inpatient setting. METHODS Data were retrieved from the Nationwide Inpatient Sample database between 1998 and 2010, yielding a total of 6,794,026 admissions with an ICD-9-CM diagnostic code for UTI. Of these, 1,833,070 patients had UTI as a primary diagnosis, or sepsis as a primary diagnosis with UTI as a secondary diagnosis: this sample was the basis of the analysis. Nationally weighted incidences and mortality rates were calculated, stratified according to sex, age, subtype of UTI and the presence of sepsis. Moreover, predictors of mortality and length of stay (LOS) beyond the 75th percentile following UTI hospitalization were examined using logistic regression models adjusted for clustering using generalized estimation equations. Finally, interaction between age and comorbidities were also assessed. RESULTS The overall incidence and mortality for UTIs are increasing with an estimated annual percent change of +0.041 and +0.046 respectively. These same trends are observed with stratification by sex; however, stratification by age shows the most important increase for patients aged between 75 to 84 years, while remaining relatively stable across other age groups. Predictors of mortality following UTI include: male gender (OR=1.184 p<0.0001), black race (OR=1.136 p<0.0001), when compared to Medicare - having Medicaid insurance (OR=1.25 p<0.0001) or being uninsured (OR=1.217 p<0.0001). Predictors of increased LOS were: male gender (OR=1.301 p<0.0001) and black race (OR=1.471 p<0.0001). Being privately insured was significantly protective (OR=0.756 p<0.0001) while median household income positively correlated with increased LOS in a stepwise fashion across all categories. CONCLUSIONS Admissions for UTI, as well as its associated mortality, have been increasing over the last decade. Male patients, those of non-white race and patients not privately insured are at increased risk of mortality during hospitalization. These findings are prospective quality indicators to adapt health care policy for particular vulnerable sub-populations. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e433 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Al'a Abdo Montreal, Canada More articles by this author Jesse Sammon Detroit, MI More articles by this author Florian Roghmann Herne, Germany More articles by this author Andreas Becker Hamburg, Germany More articles by this author Malek Meskawi Montreal, Canada More articles by this author Zhe Tian Montreal, Canada More articles by this author Hugo Lavigueur-Blouin Montreal, Canada More articles by this author Pierre I Karakiewicz Montreal, Canada More articles by this author Maxine Sun Montreal, Canada More articles by this author Quoc-Dien Trinh Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...