Inpatient Mortality Among U.S. Women Treated for Urinary Tract Infection 2016-2020.

Abstract

Importance: Urinary tract infections in adult women are commonlytreated by gynecologists and urologists.

Objective: The objective of this study was to estimate the frequency of and factors associated with mortality among women hospitalized with a primary diagnosis of a urinary tract infection (UTI).

Study design: This was a retrospective cohort study using the National Inpatient Sample of adult women hospitalized with a UTI between 2016 and 2020. Patients' demographic, hospital-level data, comorbidities, and associated diagnoses were identified using International Classification of Diseases, Tenth Revision, (ICD-10) codes. The primary outcome was death during hospitalization. Independent associations with death were analyzed using multivariable logistic regression of variables that occurred in 2% or more of hospitalizations (irrespective of outcome).

Results: A total of 330,905 hospitalizations with a primary diagnosis of UTI were identified, including 1,588 deaths (0.48%). Death was most strongly correlated with increasing age: above 85 years (adjusted odds ratio [aOR], 8.37; 95% CI, 5.69-12.30), age 76-85 years (aOR, 5.63; 95% CI, 3.83-8.27), age 66-75 years (aOR, 4.45; 95% CI, 3.01-6.57), age 51-65 years (aOR, 3.17; 95% CI, 2.12-4.73) compared with those 18-50 years. The comorbidities and diagnoses most associated with death included metastatic cancer (aOR, 4.25; 95% CI, 3.50-5.16), pneumonia (aOR, 3.68; 95% CI, 3.17-4.28), and weight loss (aOR, 2.98; 95% CI, 2.65-3.36). Bacteremia (aOR, 0.65; 95% CI, 0.45-0.95), complicated hypertension (aOR, 0.61; 95% CI, 0.52-0.72), depression (aOR, 0.75; 95% CI, 0.65-0.87), and nutritional anemia (aOR, 0.76; 95% CI, 0.60-0.96) were most associated with a decreased probability of death.

Conclusion: Death during hospitalization for a diagnosis of UTI was rare, even in critically ill and extremely elderly patients.