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. 2021 May 26;10(11):2332.
doi: 10.3390/jcm10112332.

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001-2018)

Domingo Palacios-Ceña  1 , Lidiane Lima Florencio  1 , Valentín Hernández-Barrera  2 , Cesar Fernandez-de-Las-Peñas  1 , Javier de Miguel-Diez  3 , David Martínez-Hernández  4 , David Carabantes-Alarcón  4 , Rodrigo Jimenez-García  4 , Ana Lopez-de-Andres  4 , Marta Lopez-Herranz  5
Affiliations

Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001-2018)

Domingo Palacios-Ceña et al. J Clin Med. .

Abstract

(1) Background: To assess time trends in the incidence and in-hospital outcomes of urinary tract infection (UTI) in older people (≥65 years) in Spain (2001-2018) according to sex and to identify the factors independently associated with in-hospital mortality (IHM). (2) Methods: Using the Spanish National Hospital Database, we analyzed comorbidity, procedures, diagnosis, isolated microorganisms, and outcomes. (3) Results: We included 583,693 admissions (56.76% women). In both sexes, the incidence increased with age over time (p < 0.001). In men and women, the highest IHM was found among the oldest patients (>84 years) with values of 9.16% and 8.6%, respectively. The prevalence of bacteremia increased from 4.61% to 4.98% from 2001 to 2018 (p < 0.001) and sepsis decreased from 3.16% to 1.69% (p < 0.001). The risk of dying increased with age (>84 years) (OR 3.63; 95% CI 3.5-3.78) and with almost all comorbidities. Urinary catheter was a risk factor for women (OR 1.1; 95% CI 1.02-1.18) and protective for men (OR 0.71; 95% CI 0.66-0.76). Isolation of Staphylococcus aureus increased the risk of IHM by 40% among men (OR 1.4; 95% CI 1.28-1.53). After adjusting for confounders, IHM decreased over time. (4) Conclusions: The incidence of UTIs was higher in older patients and increased over time; however, IHM decreased during the same period. Female sex, age, comorbidities, sepsis, and a Staphylococcus aureus isolation increased risk of IHM.

Keywords: aged; aged 80 and over; epidemiologic studies; hospital mortality; incidence; urinary tract infections.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Time trend, from 2001–2003 to 201620–18, in the in-hospital mortality for men and women admitted to the hospital with a principal diagnosis of urinary tract infection.
Figure 2
Figure 2
Prevalence of isolated pathogens for the first time period analyzed (2001–2003).
Figure 3
Figure 3
Prevalence of isolated pathogens for the last time period analyzed (2016–2018).
See this image and copyright information in PMC

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