Original reportAcute Pyelonephritis in US Hospitals in 1997: Hospitalization and In-hospital Mortality
Section snippets
Selected Abbreviations and Acronyms
HCUP = Healthcare Cost and Utilization Project
NIS = Nationwide Inpatient Sample
AHRQ = Agency for Healthcare Research and Quality
IRB = Institutional Review Board
Data Source
Hospitalization rates and in-hospital mortality rates were determined using the 1997 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) Release 6. The NIS is the largest inpatient database in the United States that includes all medical insurance payers. It contains over 100 clinical and non-clinical variables describing approximately 7.1 million discharges from 1012 hospitals in 22 states. This approximates a 20-percent sample of US community hospitals for 1997,
Demographic Characteristics
For every age and ethnic group, females had higher hospitalization rates than males, with the exception of Asian/Pacific islanders, native Americans, and persons aged 80 years and older, the rates of in-hospital mortality were lower (Table 1). For both males and females, hospitalization rates increased with age. Males hospitalized with acute pyelonephritis tended to be older than females (average: 51 versus 39 years) and mortality occurred almost exclusively among those aged 40 years and older.
Discussion
Acute pyelonephritis resulted in the hospitalization of 191,566 people in the US in 1997, somewhat higher than the 172,000 inpatients with an all-listed diagnosis of acute pyelonephritis discharged from short-stay nonfederal hospitals in 1993 (8). After adjustment for gender, age, race, median income of the patient's zip code, number of procedures, number of diagnoses, and major diagnosis category, there was no association of in-hospital mortality with hospital characteristics such as admission
Conclusions
We describe the 1997 incidence of hospitalization for acute pyelonephritis in the US and the risk factors for in-hospital mortality associated with acute pyelonephritis. In hospital mortality for pyelonephritis was more associated with patient rather than hospital characteristics suggesting uniform application of standard care across hospitals and populations. Males, individuals over age 60, and individuals with serious co-morbidities are at the highest risk of in-hospital mortality. While
References (9)
Treatment of Pyelonephritis in adults
Med Clin North Am.
(1995)- et al.
Hospitalization for acute pyelonephritis in Manitoba, Canada, during the period from 1989 to 1992Impact if diabetes, pregnancy, and Aboriginal origin
Clin Infect Dis.
(1996) DeathsFinal Data for 1997
Nat Center for Heath Stat.
(1999)- Nicolle LE. Management of acute uncomplicated pyelonephritis. In: Bergan T, ed. Urinary Tract Infections. Infectiology....