The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998-2011
The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998-2011
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DOI：
10.1093/ofid/ofw281
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发表时间：
2017-01-01
影响因子：
4.2
通讯作者：
Polgreen, Philip M.
中科院分区：
文献类型：
--
作者：
Simmering, Jacob E.;Tang, Fan;Polgreen, Philip M.
背景。由于抗菌药物耐药性，尿路感染 (UTI) 的门诊治疗变得越来越有限。本文的目的是报告男性和女性以及不同年龄组的尿路感染住院率随时间的变化。我们还探讨了尿路感染住院的严重程度如何变化，并描述了尿路感染住院的季节性。方法。使用全国住院患者样本，我们计算了尿路感染发病率的时间序列，并按年龄和性别对该序列进行了细分。我们拟合了一系列时间序列模型来探索趋势和季节性强度如何随年龄和性别而变化。我们使用可用混杂因素的回归来模拟严重性的变化。结果。 2011 年，约有 40 万人因尿路感染住院，估计费用达 28 亿美元。 1998 年至 2011 年间，发病率增加了 52%。女性和老年患者的增幅更大。我们发现，女性的季节性强度（夏季高峰和冬季低谷）随着时间的推移而增加，而男性则减少。对于男性和女性来说，季节性随着年龄的增长而减弱。相对于对照组并根据人口统计数据进行调整，我们发现尿路感染患者的费用增长更慢，患者出院时间更早，并且患者的死亡几率更低。结论。尿路感染住院率正在增加，并且具有季节性，在夏季达到高峰。然而，尿路感染入院的严重程度似乎正在下降，这表明以前作为门诊患者接受治疗的患者现在可能因抗菌药物耐药性增加而入院。
Background. Outpatient therapies for urinary tract infections (UTIs) are becoming limited due to antimicrobial resistance. The purpose of this paper is to report how the incidence of hospitalizations for UTIs have varied over time in both men and women and across age groups. We also explore how the severity for UTI hospitalizations has changed and describe the seasonality of UTI hospitalizations.Methods. Using the Nationwide Inpatient Sample, we compute a time-series of UTI incidence and subdivide the series by age and sex. We fit a collection of time-series models to explore how the trend and seasonal intensity varies by age and sex. We modeled changes in severity using regression with available confounders.Results. In 2011, there were approximately 400 000 hospitalizations for UTIs with an estimated cost of $ 2.8 billion. Incidence increased by 52% between 1998 and 2011. The rate of increase was larger among both women and older patients. We found that the seasonal intensity (summer peaks and winter troughs) increased over time among women while decreasing among men. For both men and women, seasonality decreased with advancing age. Relative to controls and adjusted for demographics, we found that costs among UTI patients grew more slowly, patients left the hospital earlier, and patients had lower odds of death.Conclusions. Incidence of UTI hospitalization is increasing and is seasonal, peaking in the summer. However, the severity of UTI admissions seems to be decreasing, indicating that patients previously treated as outpatients may now be admitted to the hospital due to increasing antimicrobial resistance.