Time Trends in Spain from 2001 to 2018 in the Incidence and Outcomes of Hospitalization for Urinary Tract Infections in Patients with Type 2 Diabetes Mellitus

Ana López- de-Andrés, Romana Albaladejo-Vicente, Domingo Palacios-Ceña, David Carabantes-Alarcon, José Javier Zamorano-Leon, Javier de Miguel-Diez, Marta Lopez-Herranz and Rodrigo Jiménez-García
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Ana López- de-Andrés: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Romana Albaladejo-Vicente: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Domingo Palacios-Ceña: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
David Carabantes-Alarcon: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
José Javier Zamorano-Leon: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
Javier de Miguel-Diez: Respiratory Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain
Marta Lopez-Herranz: Faculty of Nursing, Physiotherapy and Podology, Universidad Complutense de Madrid, 28040 Madrid, Spain
Rodrigo Jiménez-García: Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain

IJERPH, 2020, vol. 17, issue 24, 1-15

Abstract: We aim to examine the incidences, clinical characteristics, and in-hospital outcomes of type 2 diabetes (T2DM) patients hospitalized with urinary tract infections (UTIs) in Spain and to identify the factors associated with in-hospital mortality (IHM). A retrospective observational study was carried out with a sample that included all adult patients who were hospitalized for UTIs between 2001 and 2018 and collected in the Spanish National Health System Hospital Discharge Database. We identified 850,276 patients with UTIs (25.49% with T2DM). The incidence of UTIs increased in patients with and without diabetes from 290.76 and 74.79 cases per 100,000 inhabitants in the period from year 2001 to year 2003 to 568.45 and 144.0 in the period from 2016 to 2018, respectively ( p < 0.001). Adjusted incidence of UTIs was higher in T2DM patients (incidence rate ratio (IRR) 4.36; 95% CI 4.35–4.39). The multivariable analysis showed a significant reduction in the IHM over time for men and women with T2DM. In T2DM, patients’ higher IHM was associated with older age, comorbidities, and Staphylococcus aureus isolation. Women with T2DM had a higher risk of dying than men. The risk of IHM with an episode of UTIs was independent of the presence of T2DM (odds ratio (OR) 0.97; 95% CI 0.91–1.01). We conclude that the incidence of UTIs was over four times higher in T2DM than nondiabetic patients and has increased over time.

Keywords: urinary tract infections; type 2 diabetes mellitus; incidence; trends; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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