Risk of Mortality and Readmission among Patients with Pelvic Fracture and Urinary Tract Infection: A Population-Based Cohort Study

Ying-Cheng Chen, Cheng-Hsun Chuang, Ming-Hong Hsieh, Han-Wei Yeh, Shun-Fa Yang, Chiao-Wen Lin, Ying-Tung Yeh, Jing-Yang Huang, Pei-Lun Liao, Chi-Ho Chan and Chao-Bin Yeh
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Ying-Cheng Chen: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Cheng-Hsun Chuang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Ming-Hong Hsieh: School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Han-Wei Yeh: School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
Shun-Fa Yang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Chiao-Wen Lin: Institute of Oral Sciences, Chung Shan Medical University, Taichung 402, Taiwan
Ying-Tung Yeh: Graduate School of Dentistry, School of Dentistry, Chung Shan Medical University, Taichung 402, Taiwan
Jing-Yang Huang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Pei-Lun Liao: Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
Chi-Ho Chan: Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
Chao-Bin Yeh: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan

IJERPH, 2021, vol. 18, issue 9, 1-10

Abstract: Patients with pelvic fractures could encounter various complications during or after treatments. This cohort study investigated the risk of mortality and readmissions in patients with pelvic fractures, with or without urinary tract infections (UTIs), within 30 days following the pelvic fractures. This retrospective cohort study examined claim records from the Longitudinal Health Insurance Database 2000 (LHID2000). We selected patients hospitalized with pelvic fractures between 1997 and 2013 for study. Patients who had index data before 2000 or after 2010 ( n = 963), who died before the index date ( n = 64), who were aged <18 years ( n = 94), or who had a pelvic injury ( n = 31) were excluded. In total, the study cohort comprised 1623 adult patients; 115 had UTIs, and 1508 patients without UTIs were used as a comparison cohort. Multivariate analysis with a multiple Cox regression model and Kaplan–Meier survival analysis were performed to analyze the data. Our results showed that the 1-year mortality rate (adjusted hazard ratio [HR]: 2.32; 95% CI: 1.25–4.29) and readmission rate (adjusted HR: 1.72; 95% CI: 1.26–3.34) of the UTI group were significantly higher than those of the non-UTI group. Moreover, the Kaplan–Meier curve for the 1-year follow-up indicated that the UTI group had a higher cumulative risk of both mortality and hospital readmission compared with the non-UTI group. In conclusion, among patients with pelvic fracture, patients with UTI were associated with increased risks of mortality and readmission. Physicians must pay more attention to such patients to prevent UTIs among patients with pelvic fractures during hospitalization and conduct a follow-up after discharge within at least 1 year.

Keywords: mortality; re-admissions; urinary tract infections; pelvic fracture (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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