Impact of Urinary Tract Infections on In-Hospital Outcomes in Acute Myocardial Infarction: Insights from the National Inpatient Sample (2016-2021)

Background: Patients with acute myocardial infarction (AMI) who develop urinary tract infections (UTIs) are at a significantly higher risk of experiencing severe complications, but the impact of UTIs on in-hospital outcomes remains unclear. We aim to study the impact of UTIs on the in-hospital outcomes among patients with AMI. Methods: Data were extracted from the National Inpatient Sample database from 2016 to 2021 using ICD-10 codes to identify hospital admissions with a principal diagnosis of AMI with and without UTIs. The primary outcome was in-hospital mortality, while secondary outcomes included the incidence of cardiogenic shock, acute renal failure, gastrointestinal bleeding, stroke, and length of stay. Multivariate regression analyses were conducted to adjust for potential confounders. Results: Among 760,177 AMI patients, 33,631 (4.4%) had a concurrent UTIs. The presence of UTIs was significantly associated with adverse in-hospital outcomes, including a 10% increase in in-hospital mortality (aOR 1.10, 95% CI 1.00–1.10, P < 0.001), a 60% higher risk of cardiogenic shock (aOR 1.60, 95% CI 1.50–1.60, P < 0.001), and more than double the risk of acute renal failure (aOR 2.40, 95% CI 2.40–2.50, P < 0.001). Additionally, UTIs were associated with increased gastrointestinal bleeding (aOR 1.80, 95% CI 1.70–1.90, P < 0.001) and stroke (aOR 2.30, 95% CI 2.10–2.50, P < 0.001). Patients with UTIs also experienced a significantly longer in-hospital stay (aOR 3.20, 95% CI 3.10–3.30, P < 0.001). Conclusions : AMI patients with UTIs are associated with significantly worse in-hospital outcomes, including increased mortality and higher rates of complications.