Hospital Admission Patterns of Adult Patients with Complicated Urinary Tract Infections Who Present to the Hospital by Disease Acuity and Comorbid Conditions: How Many Admissions are Potentially Avoidable?

Link to article at PubMed

Am J Infect Control. 2021 May 30:S0196-6553(21)00382-5. doi: 10.1016/j.ajic.2021.05.013. Online ahead of print.

ABSTRACT

STUDY HYPOTHESIS: Hospital admissions for complicated urinary tract infections (cUTI) in the US are increasing but there are limited information on the acuity of patients who are admitted.

OBJECTIVE: Describe hospitalization patterns among adult cUTI patients who present to the hospital with cUTI and to determine the proportion of admissions that were of low acuity.

METHODS: A retrospective multi-center analysis using data from the Premier Healthcare Database (2013-18) was performed.

INCLUSION CRITERIA: age ≥ 18 years, cUTI diagnosis, positive blood or urine culture. Hospital admissions were stratified by presence of sepsis, systemic symptoms but no sepsis, and Charlson Comorbidity Index (CCI).

RESULTS: 187,789 patients met the inclusion criteria. The mean (SD) age was 59.7 (21.9), 40.4% were male, 29.4% had sepsis, 16.7% had at least 1 systemic symptom (but no sepsis), and 53.9% had no sepsis or systemic symptoms. The median [inter-quartile range] CCI was 1 [0, 3]. Sixty-four percent of patients were admitted to hospital, and 18.9% of admissions occurred in patients with low acuity (no sepsis or systemic symptoms and a CCI ≤ 2). The median [IQR] LOS and costs for low acuity inpatients who were admitted were 3 [2, 5] days and $5,575 [$3,607, $9,133], respectively.

CONCLUSION: Nearly 1 in 5 cUTI hospital admissions occurred in patients with low acuity, and therefore may be avoidable.

PMID:34077786 | DOI:10.1016/j.ajic.2021.05.013

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