Incidence and Predictors of Encephalopathy in Patients Admitted with Lower Urinary Tract Infections: A Nationwide Analysis

Background. There are no large-scale study assessing the incidence and predictors of encephalopathy in patients with UTI. Also, there is a lack of data on encephalopathy outcomes in patients hospitalized with UTI. We aim to evaluate the incidence, predictors, and impact of encephalopathy on the outcomes of LUTI hospitalizations Methods. Retrospective cohort study using data from the National Inpatient Sample (NIS) database (2017–2020). We included adult patients (aged ≥18 years) admitted with a principal diagnosis of lower urinary tract infection (LUTI), utilizing the International Classification of Diseases, Tenth Revision, and Clinical Modifications (ICD-10- CM) codes. Multivariate logistic and linear regression was used for data analysis. Results. Of all patients (n = 1,413,110), 15.99% had encephalopathy. Encephalopathy was associated with significantly higher mortality (aOR 1.51, 95% CI 1.36–1.69), increased risk of acute kidney injury (AKI), mechanical ventilation, intensive care unit (ICU) admission, longer hospital stays, and higher hospitalization charges. Predictors of encephalopathy included advanced age, female sex, white ethnicity, and comorbidities such as dementia, cirrhosis, bipolar disorder, epilepsy, and stroke (all P < 0.01). Conclusions. Encephalopathy significantly impacts the outcomes of LUTI hospitalizations, increasing mortality, complications, and resource utilization. Older age and neurological comorbidities are key predictors. These findings highlight the need for heightened awareness and early management of encephalopathy in LUTI patients, particularly in high-risk groups.