title: Urinary tract infections in meningioma patients: analysis of risk factors and outcomes.
abstract: BACKGROUND
  Urinary tract infections (UTIs) account for about 35% of all nosocomial infections and 75% are associated with the use of urethral catheters.
  
  
  OBJECTIVE
  The goal of this study was to evaluate preoperative factors associated with the risk of UTI and to estimate the impact of UTIs on patient outcome and resource utilization.
  
  
  METHODS
  Adult meningioma patients treated with craniotomy in US hospitals between 2002 and 2007 were queried from the Nationwide Inpatient Sample (NIS) database. Univariate and multivariate analyses that correct for sample survey design data were used to study the association of perioperative UTIs and outcomes.
  
  
  RESULTS
  In all, 46,344 patients were included. Women comprised the majority (70.0%), had lower mortality (1.2% vs 2.0%), shorter in-hospital stay (6.7 vs 7.5 days), lower hospital charges (US$76,682 vs 87,220) and higher UTI rates (6.3% vs 3.9%) than men. In multivariate analysis, female gender (odds ratio: 2.2; P < 0.0001), older age (1.4; P < 0.001), emergency room admissions (1.8; P < 0.0001), total length of stay (1.08; P < 0.0001), comorbidity score (1.04; P = 0.0147), postoperative fluid abnormalities (1.96; P < 0.0001) and pulmonary complications (1.3; P < 0.0011) were associated with UTI. UTI was associated with an additional 2.3 days of hospital stay and an incremental US$18,920 in hospital charges.
  
  
  CONCLUSIONS
  Perioperative UTIs are associated with specific comorbidities and postoperative complications. They significantly increase in-hospital length of stay and costs. Our data emphasize the need to support national efforts that are underway to reduce hospital-acquired UTIs within the neurosurgical population.
authors.affiliation: Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Department of Neurosurgery, Cedars - Sinai Medical Center, Los Angeles, California, USA.
authors.forename: K
authors.initials: K
authors.lastname: Nosova
authors.forename: M
authors.initials: M
authors.lastname: Nuño
authors.forename: D
authors.initials: D
authors.lastname: Mukherjee
authors.forename: S P
authors.initials: SP
authors.lastname: Lad
authors.forename: M
authors.initials: M
authors.lastname: Boakye
authors.forename: K L
authors.initials: KL
authors.lastname: Black
authors.forename: C G
authors.initials: CG
authors.lastname: Patil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology*; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States; D014552:Urinary Tract Infections / Q000453:epidemiology*