Epidemiology and outcomes of urosepsis among admitted patients with urinary tract infections in Danish Emergency Departments: a retrospective cohort study

OBJECTIVES: Urosepsis is a potential life-threatening complication of urinary tract infections (UTI). This study aimed to determine the incidence rate (IR) of patients hospitalised with urosepsis in the Region of Southern Denmark and identify risk factors associated with intensive care unit (ICU) admission or death within (DW) 30 days among patients admitted with UTI. METHODS: Register-based retrospective multicentre cohort study including all adults hospitalised with UTI or urosepsis in five emergency departments in the Region of Southern Denmark from January 2016 to March 2018. Demographics, microbiological findings, clinical characteristics and treatment outcomes were assessed. Multivariable logistic regression was performed to identify factors associated with a predefined composite outcome of ICU admission or DW 30 days. RESULTS: . 7-day and 30-day mortality among urosepsis patients were 3.3% and 9.4%, respectively. The composite outcome occurred more frequently in the urosepsis subgroup (13.6% vs. 7.7%). Risk factors included age >70 years (OR 2.19), urosepsis diagnosis (OR 1.74), elevated creatinine (OR 1.60), Charlson Comorbidity Index and increasing quick Sequential Organ Failure Assessment scores. CONCLUSION: Urosepsis incidence was low but increased significantly with age and was more frequent in men. 30-day mortality was 9.4%. Several risk factors were identified, which may help identify patients at increased risk of severe outcomes.