Risk factors for hospital readmission following complicated urinary tract infection.

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.

Scientific reports. 2021 Mar 25*** epublish ***

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

Department of Medicine E, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel. ., Department of Medicine E, Beilinson Hospital, Rabin Medical Center, Petah-Tiqva, Israel., Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut D'Investigació Biomèdica de Bellvitge (IDIBELL), Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III (ISCIII), Madrid, Spain., AiCuris Anti-Infective Cures GmbH, Wuppertal, Germany., Department of Infection Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, UK., Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

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