Risk factors for hospital readmission in survivors of complicated UTI

Survivors of complicated urinary tract infections (cUTI) are commonly readmitted for recurrent UTI, usually related to other medical conditions that require urinary interventions, a recent study has found.

Researchers conducted a retrospective analysis of 742 survivors (median age, 68 years, 43.3 percent men) of cUTI. The outcome of interest was 60-day hospital readmission, and patient medical records were accessed for pertinent information, such as demographic factors, infection management, and clinical and microbiological data.

Overall, 149 survivors needed to be readmitted within 60 days of index hospitalization, while the remaining 593 did not. The former group tended to be predominantly male and older, as well as were more likely to report having had UTI in the prior year. The most common reason for readmission was recurrent cUTI (46.4 percent).

Multivariable analysis confirmed that older age was a significant risk factor for 60-day readmission, with the likelihood increasing by 2 percent for each additional year increase in age (odds ratio [OR], 1.02, 95 percent confidence interval [CI], 1.005–1.03). UTI in the previous year was likewise confirmed as a risk factor (OR, 1.8, 95 percent CI, 1.14–2.83).

Notably, medical interventions involving the urinary tract, such as the insertion of percutaneous nephrostomy (OR, 3.68, 95 percent CI, 1.67–8.13) and of an indwelling bladder catheter (OR, 1.62, 95 percent CI, 1.07–2.45), emerged as strong correlates of 60-day readmission. The same was true for cancer (OR, 1.7, 95 percent CI, 1.05–2.77).

“These findings suggest that anatomic abnormalities/dysfunction of the urinary tract are major risk factors for readmission,” the researchers said.