PREVALENCE AND HEALTHCARE BURDEN OF COMPLICATED URINARY TRACT INFECTIONS AMONG HOSPITALIZED PATIENTS IN THE UNITED STATES
Author(s)
Rena C. Moon, MPH, MD1, Joy David, BS2, Ning A. Rosenthal, MPH, PhD, MD2;
1Premier Inc, Associate Principal, Charlotte, NC, USA, 2Premier Inc, Charlotte, NC, USA
1Premier Inc, Associate Principal, Charlotte, NC, USA, 2Premier Inc, Charlotte, NC, USA
OBJECTIVES: Urinary tract infections (UTIs) are among the most common bacterial infections. Complicated UTIs (cUTIs), defined as a symptomatic UTI which goes beyond the bladder in women or men, and include pyelonephritis, febrile or bacteremic UTI, and catheter-associated UTI, are associated with greater morbidity, higher risk of treatment failure and hospitalizations, and longer course of antibiotics. This study aimed to describe the prevalence and healthcare burden of cUTI among hospitalized patients in the United States.
METHODS: A retrospective cross-sectional study was performed using Premier Healthcare Database for adult (aged≥18 years) inpatients discharged between 1/1/2018−12/31/2024. Pregnant patients were excluded. Diagnosis and procedure codes were used to identify evidence of cUTI.
RESULTS: Among 40,814,725 hospitalized adult patients, 1,064,418 (2.6%) had evidence of cUTI. More than half of patients with cUTI were women (55%) and 60 years old or older (76%). Compared to hospitalized patients without cUTI, patients with cUTI were more likely to be older (mean age 70 vs. 65 years), and have Medicare (73% vs.59%, all p<0.001). Patients with cUTI were also more likely to have diabetes (45% vs. 37%) and severe renal dysfunction (50% vs. 31%, all p<0.001) than patients without cUTI. The prevalence of cUTI among hospitalized patients increased between 2018 and 2024, from 2.3-2.4% in 2018-2020 to 3.0-3.2% in 2023-2024. The most common type of cUTI was other without pyelonephritis (47%), followed by catheter-associated UTI (27%), and pyelonephritis (26%). In-hospital mortality (3.2% vs. 1.3%) and hospitalization cost (median $11,873 vs. $8,705) were both higher among patients with cUTI compared to those without (both p<0.001).
CONCLUSIONS: Prevalence of cUTI among hospitalized adult patients increased between 2018 and 2024. Compared to hospitalized patients without cUTI, cUTI patients had higher in-hospital mortality and hospitalization cost indicating increased healthcare burden. Further research is needed to understand its association with antibiotic resistance.
METHODS: A retrospective cross-sectional study was performed using Premier Healthcare Database for adult (aged≥18 years) inpatients discharged between 1/1/2018−12/31/2024. Pregnant patients were excluded. Diagnosis and procedure codes were used to identify evidence of cUTI.
RESULTS: Among 40,814,725 hospitalized adult patients, 1,064,418 (2.6%) had evidence of cUTI. More than half of patients with cUTI were women (55%) and 60 years old or older (76%). Compared to hospitalized patients without cUTI, patients with cUTI were more likely to be older (mean age 70 vs. 65 years), and have Medicare (73% vs.59%, all p<0.001). Patients with cUTI were also more likely to have diabetes (45% vs. 37%) and severe renal dysfunction (50% vs. 31%, all p<0.001) than patients without cUTI. The prevalence of cUTI among hospitalized patients increased between 2018 and 2024, from 2.3-2.4% in 2018-2020 to 3.0-3.2% in 2023-2024. The most common type of cUTI was other without pyelonephritis (47%), followed by catheter-associated UTI (27%), and pyelonephritis (26%). In-hospital mortality (3.2% vs. 1.3%) and hospitalization cost (median $11,873 vs. $8,705) were both higher among patients with cUTI compared to those without (both p<0.001).
CONCLUSIONS: Prevalence of cUTI among hospitalized adult patients increased between 2018 and 2024. Compared to hospitalized patients without cUTI, cUTI patients had higher in-hospital mortality and hospitalization cost indicating increased healthcare burden. Further research is needed to understand its association with antibiotic resistance.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH125
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Urinary/Kidney Disorders