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Rates of hospitalization for urinary tract infections among medicaid-insured individuals by spina bifida status, Tennessee 2005-2013.

Authors
  • Gebretsadik, Tebeb1
  • Cooper, William O2
  • Ouyang, Lijing3
  • Thibadeau, Judy3
  • Markus, Tiffanie4
  • Cook, Jessica2
  • Tesfaye, Sarah2
  • Mitchel, Edward F4
  • Newsome, Kimberly3
  • Carroll, Kecia N5
  • 1 Department of Biostatistics, 2525 West End, Suite, 1100, Vanderbilt School of Medicine, Nashville, TN, USA.
  • 2 Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA.
  • 3 Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • 4 Department of Health Policy, 2525 West End Ave., Suite 1200, 1275, Vanderbilt University Medical Center, Nashville, TN, USA.
  • 5 Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: [email protected]
Type
Published Article
Journal
Disability and health journal
Publication Date
Oct 01, 2020
Volume
13
Issue
4
Pages
100920–100920
Identifiers
DOI: 10.1016/j.dhjo.2020.100920
PMID: 32402791
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Individuals with spina bifida are at increased risk for urinary tract infection (UTI), however there are few population-based investigations of the burden of UTI hospitalizations. We assessed rates and risk factors for UTI hospitalization in individuals with and without spina bifida. We conducted a retrospective cohort study to estimate rates of UTI hospitalization by spina bifida status. We included individuals enrolled in Tennessee Medicaid who lived in one of the Emerging Infections Program's Active Bacterial Surveillance counties between 2005 and 2013. Spina bifida was primarily defined and UTI hospitalizations were identified using International Classification of Diseases, Ninth Revision diagnoses. We also studied a subset without specific health conditions potentially associated with UTI. We used Poisson regression to calculate rate ratios (RR) of UTIs for individuals with versus without spina bifida, adjusting for race, sex and age group. Over the 9-years, 1,239,362 individuals were included and 2,493 met criteria for spina bifida. Individuals with spina bifida had over a four-fold increased rate of UTI hospitalization than those without spina bifida-in the overall study population and in the subset without specific, high-risk conditions (adjusted rate ratios: 4.41, 95% confidence intervals: 3.03, 6.43) and (4.87, 95% CI: 2.99, 7.92), respectively. We detected differences in rates of UTI hospitalization by race and sex in individuals without spina bifida that were not seen among individuals with spina bifida. Individuals with spina bifida had increased rates of UTI hospitalizations, and associated demographic patterns differed from those without spina bifida. Copyright © 2020 Elsevier Inc. All rights reserved.

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