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SUFU 2022: Incidence of Urinary Tract Infections Between Neurogenic and Non-Neurogenic Bladder Dysfunction Patients Performing Intermittent Catheterization - An Analysis of Marketscan Data

(UroToday.com) This study compares UTI incidence and severity among intermittent catheter (IC) users with neurogenic (NLUTD) and non-neurogenic diagnoses. Analysis of health insurance claims data from the IBM MarketScan Database (commercial Preferred-Provider Organization and Medicare supplemental claims) between January 1, 2015 – December 31, 2019, was presented. MarketScan® is a health insurance claim database, which. Three cohorts were created:
  1. IC-users with NLUTD; IC-users
  2. IC-users without NLUTD (non-NLUTD)
  3. General population group without IC use (GEN; 10:1 age-and-sex-matched)
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Patients were followed for one-year after initial IC utilization or from a random index date for the general population. UTI claims were identified by primary or secondary diagnosis codes. UTI incidence, hospitalizations and length of hospital stay were compared. Kaplan Meier curves were used to analyze time to first UTI.

This was a large database of IC users as noted in this diagram; 6,944 NLUTD patients and 5,102 non-NLUTD patients who newly started IC, and 120,460 GEN people without IC use. The 1-year incidence of UTI in those performing IC was 54.9% in NLUTD and 38.9% in non-NLUTD patients compared to 9.1% in GEN (p<0.001 NLUTD vs. GEN, p<0.001 NLUTD vs. non-NLUTD, p<0.001 NLUTD vs. non-NLUTD).

  • IC users had a significantly higher incidence of UTIs than general population controls not using IC (p<0.001)
  • NLUTD IC users had a significantly higher risk of UTIs compared to non-NLUTD IC users and GEN (p<0.001)
    • 12-fold higher for those with NLUTD
    • 4-fold higher for those without NLUTD
  • NLUTD IC users had a significantly higher risk of having 3+ UTIs than non-NLUTD and GEN
    • 17.1% NLUTD vs. 9.6% non-NLUTD vs. 0.6% GEN; p<0.001
  • NLUTD IC users had a significantly higher risk of UTI-associated hospitalization than non-NLUTD and GEN individuals (p<0.001)
  • NLUTD IC users were hospitalized significantly longer than non-NLUTD and GEN individuals(p<0.001)

This data indicate that neurologic disease is an independent risk factor for UTIs among IC users. Hospitalization data showed a:

  • 3-fold higher hospitalization risk for those with NLUTD than non-NLUTD individuals
  • 18-fold higher hospitalization risk for those with NLUTD than GEN population
  • 6-fold higher hospitalization risk for those with non-NLUTD than GEN population

Funding: Coloplast

Presented by: Blayne Welk, MD, FRCSC, MSC,1 Sara Lenherr, MD,2 Yasir Santiago-Lastra, MD,3 Melanie Goodman Keiser, PhD,4 Holly Norman, PhD4, Christopher Elliott, MD, PhD,5,6

  1. Department of Surgery (Urology), Western University, Canada
  2. Department of Surgery (Urology), University of Utah, Salt Lake City
  3. Depart. of Urology, University of San Diego Health
  4. Medical Affairs, Coloplast, Minneapolis
  5. Department of Urology-Divisions, Stanford University Medical Center, Stanford, CA
  6. Division of Urology, Santa Clara Valley Medical Center, San Jose, CA

Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health at the 2022 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting, February 22 - 26, 2022