PUK39 URINARY TRACT INFECTIONS (UTIS) AFTER UROGENITAL PROCEDURES AND RELATED OUTCOMES AND COSTS: ANALYSIS OF DATA FROM THE NATIONAL HOSPITAL INFORMATION SYSTEM

Abstract

The purpose of this study was to evaluate the proportion of Urinary Tract Infections (UTIs) after urogenital procedures and the associations between UTIs and in-hospital mortality, length of stay (LOS) and costs using the Hospital Information System of Italy. The National Hospital Discharge Database was retrospectively reviewed for all admissions between 2010 and 2014 with a urogenital procedure in the primary or secondary fields. UTIs were identified according to the presence of primary or secondary diagnosis of pyelonephritis; UTI, site not specified; other post-operative infections; other infections due to medical care; cystitis; and urethritis. The associations between the presence of a UTI and outcomes or costs were assessed with the Mann–Whitney unpaired test and Pearson's Chi-square test, when appropriate, and multivariable generalized linear models. A further sensitivity analysis was performed considering UTIs as only the presence of a primary or secondary diagnosis of a post-operative infection. Within the 5-year study period, we selected 272,133 acute admitted inpatients with a reported urogenital procedure; the proportion of admitted patients with UTIs was 7.0% (95% CI: 6.9% - 7.4%). The multivariate model showed no association between in-hospital mortality and the presence of a UTI (OR 0.95; 95% CI: 0.83 - 1.10) but indicated a strong association between in-hospital mortality and the diagnosis of a post-operative infection (OR 2.42; 95% CI: 1.26 - 4.66). Compared with patients without UTIs, those with UTIs had significantly longer hospital stays and mean hospitalization costs (IRRadj 1.50; 95% CI: 1.48 - 1.51 and βadj 1.19; 95% CI: 1.18 - 1.21, respectively). In this study we demonstrated that the presence of UTI after a urogenital procedure is associated with a prolonged hospital stay and elevated mean hospitalization costs. The study may help advance out understanding of the outcomes and costs related to UTIs after urogenital procedures in the Italian context.