Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)
(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 Nat...
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MDPI AG
2021-05-01
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author | Domingo Palacios-Ceña Lidiane Lima Florencio Valentín Hernández-Barrera Cesar Fernandez-de-las-Peñas Javier de Miguel-Diez David Martínez-Hernández David Carabantes-Alarcón Rodrigo Jimenez-García Ana Lopez-de-Andres Marta Lopez-Herranz |
author_facet | Domingo Palacios-Ceña Lidiane Lima Florencio Valentín Hernández-Barrera Cesar Fernandez-de-las-Peñas Javier de Miguel-Diez David Martínez-Hernández David Carabantes-Alarcón Rodrigo Jimenez-García Ana Lopez-de-Andres Marta Lopez-Herranz |
author_sort | Domingo Palacios-Ceña |
collection | DOAJ |
description | (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 (<i>p</i> < 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 (<i>p</i> < 0.001) and sepsis decreased from 3.16% to 1.69% (<i>p</i> < 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 <i>Staphylococcus aureus</i> 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 <i>Staphylococcus aureus</i> isolation increased risk of IHM. |
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format | Article |
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institution | Directory Open Access Journal |
issn | 2077-0383 |
language | English |
last_indexed | 2024-03-10T11:00:49Z |
publishDate | 2021-05-01 |
publisher | MDPI AG |
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series | Journal of Clinical Medicine |
spelling | doaj.art-baa875508bb34517a1a94356560d1fe82023-11-21T21:32:27ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011011233210.3390/jcm10112332Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018)Domingo Palacios-Ceña0Lidiane Lima Florencio1Valentín Hernández-Barrera2Cesar Fernandez-de-las-Peñas3Javier de Miguel-Diez4David Martínez-Hernández5David Carabantes-Alarcón6Rodrigo Jimenez-García7Ana Lopez-de-Andres8Marta Lopez-Herranz9Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, SpainDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, SpainPreventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, SpainDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, SpainRespiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainDepartment of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, SpainFaculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain(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 (<i>p</i> < 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 (<i>p</i> < 0.001) and sepsis decreased from 3.16% to 1.69% (<i>p</i> < 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 <i>Staphylococcus aureus</i> 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 <i>Staphylococcus aureus</i> isolation increased risk of IHM.https://www.mdpi.com/2077-0383/10/11/2332urinary tract infectionsagedaged 80 and overincidencehospital mortalityepidemiologic studies |
spellingShingle | Domingo Palacios-Ceña Lidiane Lima Florencio Valentín Hernández-Barrera Cesar Fernandez-de-las-Peñas Javier de Miguel-Diez David Martínez-Hernández David Carabantes-Alarcón Rodrigo Jimenez-García Ana Lopez-de-Andres Marta Lopez-Herranz Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) Journal of Clinical Medicine urinary tract infections aged aged 80 and over incidence hospital mortality epidemiologic studies |
title | Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) |
title_full | Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) |
title_fullStr | Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) |
title_full_unstemmed | Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) |
title_short | Trends in Incidence and Outcomes of Hospitalizations for Urinary Tract Infection among Older People in Spain (2001–2018) |
title_sort | trends in incidence and outcomes of hospitalizations for urinary tract infection among older people in spain 2001 2018 |
topic | urinary tract infections aged aged 80 and over incidence hospital mortality epidemiologic studies |
url | https://www.mdpi.com/2077-0383/10/11/2332 |
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