Inpatient Mortality Among U.S. Women Treated for Urinary Tract Infection 2016–2020

Importance Urinary tract infections in adult women are commonlytreated by gynecologists and urologists. Objective The objective of this study was to estimate the frequency of and factors associated with mortality among women hospitalized with a primary diagnosis of a urinary tract infection (UTI). Study Design This was a retrospective cohort study using the National Inpatient Sample of adult women hospitalized with a UTI between 2016 and 2020. Patients' demographic, hospital-level data, comorbidities, and associated diagnoses were identified using International Classification of Diseases, Tenth Revision, (ICD-10) codes. The primary outcome was death during hospitalization. Independent associations with death were analyzed using multivariable logistic regression of variables that occurred in 2% or more of hospitalizations (irrespective of outcome). Results A total of 330,905 hospitalizations with a primary diagnosis of UTI were identified, including 1,588 deaths (0.48%). Death was most strongly correlated with increasing age: above 85 years (adjusted odds ratio [aOR], 8.37; 95% CI, 5.69–12.30), age 76–85 years (aOR, 5.63; 95% CI, 3.83–8.27), age 66–75 years (aOR, 4.45; 95% CI, 3.01–6.57), age 51–65 years (aOR, 3.17; 95% CI, 2.12–4.73) compared with those 18–50 years. The comorbidities and diagnoses most associated with death included metastatic cancer (aOR, 4.25; 95% CI, 3.50–5.16), pneumonia (aOR, 3.68; 95% CI, 3.17–4.28), and weight loss (aOR, 2.98; 95% CI, 2.65–3.36). Bacteremia (aOR, 0.65; 95% CI, 0.45–0.95), complicated hypertension (aOR, 0.61; 95% CI, 0.52–0.72), depression (aOR, 0.75; 95% CI, 0.65–0.87), and nutritional anemia (aOR, 0.76; 95% CI, 0.60–0.96) were most associated with a decreased probability of death. Conclusion Death during hospitalization for a diagnosis of UTI was rare, even in critically ill and extremely elderly patients.