Risk factors for hospital readmission following complicated urinary tract infection
Abstract Hospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great im...
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Nature Portfolio
2021
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oai:doaj.org-article:f3ef74d6a1a54d4fa9f745b66a9a6bfe2021-12-02T17:04:34ZRisk factors for hospital readmission following complicated urinary tract infection10.1038/s41598-021-86246-72045-2322https://doaj.org/article/f3ef74d6a1a54d4fa9f745b66a9a6bfe2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86246-7https://doaj.org/toc/2045-2322Abstract Hospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great importance. In this study we evaluated potentially preventable risk factors for 60-day readmission in patients surviving hospitalization for complicated urinary tract infection (cUTI). This was a multinational, multicentre retrospective cohort study conducted in Europe and the Middle East. Our cohort included survivors of hospitalization due to cUTI during the years 2013–2014. The primary outcome was 60-day readmission following index hospitalization. Patient characteristics that could have influenced readmission: demographics, infection presentation and management, microbiological and clinical data; were collected via computerized medical records from infection onset up to 60 days after hospital discharge. Overall, 742 patients were included. The cohort median age was 68 years (interquartile range, (IQR) 55–80) and 43.3% (321/742) of patients were males. The all-cause 60-day readmission rate was 20.1% (149/742) and more than half were readmitted for infection [57.1%, (80/140)]. Recurrent cUTI was the most frequent cause for readmission [46.4% (65/140)]. Statistically significant risk factors associated with 60-day readmission in multivariable analysis were: older age (odds ratio (OR) 1.02 for an one-year increment, confidence interval (CI) 1.005–1.03), diabetes mellitus (OR 1.63, 95% CI 1.04–2.55), cancer (OR 1.7, 95% CI 1.05–2.77), previous urinary tract infection (UTI) in the last year (OR 1.8, 95% CI: 1.14–2.83), insertion of an indwelling bladder catheter (OR 1.62, 95% CI 1.07–2.45) and insertion of percutaneous nephrostomy (OR 3.68, 95% CI 1.67–8.13). In conclusion, patients surviving hospitalization for cUTI are frequently re-hospitalized, mostly for recurrent urinary infections associated with a medical condition that necessitated urinary interventions. Interventions to avoid re-admissions should target these patients.Tanya BabichNoa Eliakim-RazAdi TurjemanMiquel PujolJordi CarratalàEvelyn ShawAina Gomila GrangeCuong VuongIbironke AddyIrith WiegandSally GrierAlasdair MacGowanChristiane VankLeo van den HeuvelLeonard LeiboviciNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021) |
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DOAJ |
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DOAJ |
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EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Tanya Babich Noa Eliakim-Raz Adi Turjeman Miquel Pujol Jordi Carratalà Evelyn Shaw Aina Gomila Grange Cuong Vuong Ibironke Addy Irith Wiegand Sally Grier Alasdair MacGowan Christiane Vank Leo van den Heuvel Leonard Leibovici Risk factors for hospital readmission following complicated urinary tract infection |
| description |
Abstract Hospital readmissions following severe infections are a major economic burden on the health care system and have a negative influence on patients' quality of life. Understanding the risk factors for readmission, particularly the extent to which they could be prevented, is of a great importance. In this study we evaluated potentially preventable risk factors for 60-day readmission in patients surviving hospitalization for complicated urinary tract infection (cUTI). This was a multinational, multicentre retrospective cohort study conducted in Europe and the Middle East. Our cohort included survivors of hospitalization due to cUTI during the years 2013–2014. The primary outcome was 60-day readmission following index hospitalization. Patient characteristics that could have influenced readmission: demographics, infection presentation and management, microbiological and clinical data; were collected via computerized medical records from infection onset up to 60 days after hospital discharge. Overall, 742 patients were included. The cohort median age was 68 years (interquartile range, (IQR) 55–80) and 43.3% (321/742) of patients were males. The all-cause 60-day readmission rate was 20.1% (149/742) and more than half were readmitted for infection [57.1%, (80/140)]. Recurrent cUTI was the most frequent cause for readmission [46.4% (65/140)]. Statistically significant risk factors associated with 60-day readmission in multivariable analysis were: older age (odds ratio (OR) 1.02 for an one-year increment, confidence interval (CI) 1.005–1.03), diabetes mellitus (OR 1.63, 95% CI 1.04–2.55), cancer (OR 1.7, 95% CI 1.05–2.77), previous urinary tract infection (UTI) in the last year (OR 1.8, 95% CI: 1.14–2.83), insertion of an indwelling bladder catheter (OR 1.62, 95% CI 1.07–2.45) and insertion of percutaneous nephrostomy (OR 3.68, 95% CI 1.67–8.13). In conclusion, patients surviving hospitalization for cUTI are frequently re-hospitalized, mostly for recurrent urinary infections associated with a medical condition that necessitated urinary interventions. Interventions to avoid re-admissions should target these patients. |
| format |
article |
| author |
Tanya Babich Noa Eliakim-Raz Adi Turjeman Miquel Pujol Jordi Carratalà Evelyn Shaw Aina Gomila Grange Cuong Vuong Ibironke Addy Irith Wiegand Sally Grier Alasdair MacGowan Christiane Vank Leo van den Heuvel Leonard Leibovici |
| author_facet |
Tanya Babich Noa Eliakim-Raz Adi Turjeman Miquel Pujol Jordi Carratalà Evelyn Shaw Aina Gomila Grange Cuong Vuong Ibironke Addy Irith Wiegand Sally Grier Alasdair MacGowan Christiane Vank Leo van den Heuvel Leonard Leibovici |
| author_sort |
Tanya Babich |
| title |
Risk factors for hospital readmission following complicated urinary tract infection |
| title_short |
Risk factors for hospital readmission following complicated urinary tract infection |
| title_full |
Risk factors for hospital readmission following complicated urinary tract infection |
| title_fullStr |
Risk factors for hospital readmission following complicated urinary tract infection |
| title_full_unstemmed |
Risk factors for hospital readmission following complicated urinary tract infection |
| title_sort |
risk factors for hospital readmission following complicated urinary tract infection |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/f3ef74d6a1a54d4fa9f745b66a9a6bfe |
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