Impact of urinary tract infections on in-hospital outcomes among prostate cancer patients: An NIS-based analysis.

Abstract

e17013 Background: Prostate cancer, the second most diagnosed cancer in men worldwide, predominantly affects older individuals who may experience obstructive or irritative urinary symptoms. However, the influence of UTIs on in-hospital outcomes for prostate cancer patients remains understudied. This investigation assessed the impact of UTIs on outcomes such as mortality, complications, and resource utilization among hospitalized prostate cancer patients, using data from a nationally representative sample. Methods: This retrospective cohort study analyzed the National Inpatient Sample (NIS) database from 2016 to 2021. Adult patients hospitalized with primary or secondary diagnoses of prostate cancer were identified using relevant ICD-10 codes and were stratified based on the presence or absence of UTI. The primary outcome was in-hospital mortality, while secondary outcomes included length of stay (LOS), total hospitalization cost, and complications such as sepsis, septic shock, acute kidney injury (AKI), and bleeding requiring transfusion. Multivariable logistic regression was used to adjust for demographics and comorbidities. Results: From 224,645 hospitalizations of prostate cancer, 8,217 (3.7%) had comorbid UTIs. Patients with UTIs were older, predominantly White, with a higher burden of comorbid conditions including diabetes, hypertension, anemia, chronic kidney disease, and heart failure. After adjustment, presence of UTI was associated with increased odds of sepsis (adjusted odds ratio [aOR] 3.56, 95% CI 3.39–3.75), septic shock (aOR 2.17, 95% CI 1.96–2.36), AKI (aOR 2.14, 95% CI 2.03–2.25), bleeding requiring transfusion (aOR 2.24, 95% CI 2.04–2.46), and longer LOS (aOR 1.30, 95% CI 1.28–1.33). The presence of UTI was associated with lower odds of in-hospital mortality (aOR 0.87, 95% CI 0.77–0.98, p =0.0188) and reduced hospitalization costs (aOR 0.97, 95% CI 0.95–0.98, p =0.0001). Conclusions: UTIs significantly increased morbidity among prostate cancer hospitalizations, with higher odds of complications such as sepsis, septic shock, and AKI, as well as longer hospital stays. Interestingly, UTIs were associated with lower in-hospital mortality and reduced costs, potentially reflecting aggressive management and early intervention in these patients. Further studies should explore targeted strategies to improve care outcomes in this vulnerable population.