围手术期尿路感染 (PUTI) 在美国很常见，是导致医疗费用高昂的一个重要原因。目前缺乏关于全子宫切除术（TH）术后PUTI危险因素的大型研究。我们利用2010年至2019年445,380名患者的全国住院患者样本（NIS）进行回顾性研究，分析PUTI的危险因素和年发病率与围手术期 TH 相关。总共在 9087 名患者中发现了 PUTI，发病率为 2.0%。不同年龄组的PUTI发生率存在显着差异（P<0.001）。两组之间在保险类型、医院地点、病床大小和医院类型方面始终存在显着差异（P<0.001）。 PUTI 患者的合并症数量显着增加 (P < 0.001)。不出所料，PUTI 患者的中位住院时间较长（5 天 vs. 2 天；P<0.001），院内死亡率较高（0.1% 至 1.1%；P<0.001）。因此，由于 PUTI 增加了医疗费用，总体住院费用中位数增加了 27,500 美元（60,426 美元 vs. 32,926 美元，P < 0.001）。 PUTI 患者择期住院的情况较少见（66.8% vs. 87.6%；P < 0.001）。根据多因素Logistic回归研究，TH后PUTI的风险变量如下： 45岁以上；合并症数量（≥ 1）；医院床位尺寸（中、大）；教学医院；医院区域（南、西）；术前合并症（酗酒、缺乏性贫血、慢性失血性贫血、充血性心力衰竭、糖尿病、药物滥用、高血压、甲状腺功能减退、淋巴瘤、液体和电解质紊乱、转移性癌症、其他神经系统疾病、瘫痪、周围血管疾病、精神病、肺病循环障碍、肾功能衰竭、无转移的实体瘤、瓣膜病、体重减轻）；和并发症（败血症、急性心肌梗塞、深静脉血栓、胃肠道出血、肺炎、中风、伤口感染、伤口破裂、出血、肺栓塞、输血、术后谵妄）。研究结果表明，识别这些危险因素可以改善TH 患者 PUTI 的预防策略和管理。应在手术前进行咨询，以减少 PUTI 的发生率。在医疗实践中，识别危险因素可以改善患者的预防和治疗策略。我们利用 2010 年至 2019 年 445,380 名患者的全国住院患者样本 (NIS) 进行了一项回顾性研究，分析了围手术期与 TH 相关的 PUTI 的危险因素和年发生率。总共在 9087 名患者中发现了 PUTI，发病率为 2.0%。我们发现，住院时间、医疗费用、既往合并症数量、医院规模、教学医院和地区的增加也在 UTI 风险中发挥着作用。Urogynecology。© 2024。作者（ s）。

Perioperative urinary tract infections (PUTIs) are common in the United States and are a significant contributor to high healthcare costs. There is a lack of large studies on the risk factors for PUTIs after total hysterectomy (TH).We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively.PUTIs were found in 9087 patients overall, showing a 2.0% incidence. There were substantial differences in the incidence of PUTIs based on age group (P < 0.001). Between the two groups, there was consistently a significant difference in the type of insurance, hospital location, hospital bed size, and hospital type (P < 0.001). Patients with PUTIs exhibited a significantly higher number of comorbidities (P < 0.001). Unsurprisingly, patients with PUTIs had a longer median length of stay (5 days vs. 2 days; P < 0.001) and a higher in-hospital death rate (from 0.1 to 1.1%; P < 0.001). Thus, the overall hospitalization expenditures increased by $27,500 in the median ($60,426 vs. $32,926, P < 0.001) as PUTIs increased medical costs. Elective hospitalizations are less common in patients with PUTIs (66.8% vs. 87.6%; P < 0.001). According to multivariate logistic regression study, the following were risk variables for PUTIs following TH: over 45 years old; number of comorbidities (≥ 1); bed size of hospital (medium, large); teaching hospital; region of hospital(south, west); preoperative comorbidities (alcohol abuse, deficiency anemia, chronic blood loss anemia, congestive heart failure, diabetes, drug abuse, hypertension, hypothyroidism, lymphoma, fluid and electrolyte disorders, metastatic cancer, other neurological disorders, paralysis, peripheral vascular disorders, psychoses, pulmonary circulation disorders, renal failure, solid tumor without metastasis, valvular disease, weight loss); and complications (sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal hemorrhage, pneumonia, stroke, wound infection, wound rupture, hemorrhage, pulmonary embolism, blood transfusion, postoperative delirium).The findings suggest that identifying these risk factors can lead to improved preventive strategies and management of PUTIs in TH patients. Counseling should be done prior to surgery to reduce the incidence of PUTIs.In medical practice, the identification of risk factors can lead to improved patient prevention and treatment strategies. We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. PUTIs were found in 9087 patients overall, showing a 2.0% incidence. We found that noted increased length of hospital stay, medical cost, number of pre-existing comorbidities, size of the hospital, teaching hospitals, and region to also a play a role in the risk of UTI's.Urogynecology.© 2024. The Author(s).