Elderly Men More Likely to be Hospitalized for UTIs

Women may be much more prone to suffer urinary tract infections, but men are more likely to be hospitalized for UTI treatment, according to a recent study in the World Journal of Urology.

Between 2006 and 2009, 10.8 million patients presented to US emergency departments for the treatment of UTI, and 16.7 % (1.8 million) were admitted to the hospital for further management.

The study authors cited previous research that found a tenfold increase in cost when patients required hospital admission for UTI management. They hope that identifying predictors of hospital admission may help contain the rising costs of care. In addition to male gender, other predictors for inpatient admission included advancing age and kidney infection.

Older men get UTIs for different reasons than women. “In general, men get UTIs when there is some structural abnormality of the urinary system—either an enlarged prostate, inflammation of the prostate, or some other process that impedes the flow of urine,” says lead author Jesse Sammon, DO, a researcher at the Vattikuti Urology Institute of Henry Ford Hospital in Detroit. “Accordingly, there is a higher probability of needing to address these concomitant structural abnormalities associated with the UTI.” 

Researchers also found a rapid rise in ED visits for UTI that exceeded all previous estimates. From 2006 to 2009, there was an average of 2.7 million emergency department visits each year for UTI, leading to 450,136 admissions. The majority of these are women. 

How can primary care providers help to decrease this burden? “One strategy that has proven very cost-effective for otherwise healthy women with recurrent, symptomatic UTIs is allowing for self-treatment with a standing prescription,” Dr Sammon says. “Unsurprisingly, women are very good at telling when they have a UTI.”

“There are several reasons to be hopeful that this trend in ED management of UTI will change from a fairly steady rise to a decrease,” he adds. “Access to primary care or acute care outside of an ED may decrease ED usage.” One of the first provisions of the Affordable Care Act allows young people to stay on their parents’ insurance plans until age 27, a peak time in female use of the emergency department for UTI treatment.

“Further, the rise of retail acute care will hopefully help to alleviate some of this (burden)—diagnosis and treatment of UTI is rapid and may be ideally suited for care in these environments, particularly for young, otherwise healthy females,” Dr Sammon says. 

—Colleen B. Mullarkey

Reference

Sammon JD, Sharma P, Rahbar H, Roghmann F, Ghani KR, Sukumar S, et al. Predictors of admission in patients presenting to the emergency department with urinary tract infection. World J Urol. 2013 Sep 27. [Epub ahead of print].