Signal Center for Health Innovation,The University of Iowa Health Ventures',Coralville, Iowa,USA.
Department of Biostatistics,The University of Iowa,Iowa City, Iowa,USA.
Epidemiol Infect. 2018 Feb;146(3):386-393. doi: 10.1017/S0950268817002965. Epub 2018 Jan 8.
The incidence of urinary tract infections (UTIs) is seasonal, and this seasonality may be explained by changes in weather, specifically, temperature. Using data from the Nationwide Inpatient Sample, we identified the geographic location for 581 813 hospital admissions with the primary diagnosis of a UTI and 56 630 773 non-UTI hospitalisations in the United States. Next, we used data from the National Climatic Data Center to estimate the monthly average temperature for each location. Using a case-control design, we modelled the odds of a hospital admission having a primary diagnosis of UTI as a function of demographics, payer, location, patient severity, admission month, year and the average temperature for the admission month. We found, after controlling for patient factors and month of admission, the odds of a UTI diagnosis increased with higher temperatures in a dose-dependent manner. For example, relative to months with average temperatures of 5-7.5 °C, an admission in a month with an average temperature of 27.5-30 °C has 20% higher odds of a primary diagnosis of UTI. However, in months with extremely high average temperatures (above 30 °C), the odds of a UTI admissions decrease, perhaps due to changes in behaviour. Thus, at a population level, UTI-related hospitalisations are associated with warmer weather.
尿路感染(UTI)的发病率具有季节性,这种季节性可能与天气变化有关,特别是与温度变化有关。我们利用来自全美住院患者样本(Nationwide Inpatient Sample)的数据,确定了美国 581813 例以 UTI 为主要诊断的住院患者和 56630773 例非 UTI 住院患者的地理位置。接下来,我们利用国家气候数据中心的数据来估算每个地点的月平均温度。我们采用病例对照设计,以住院患者的主要诊断为 UTI 为因变量,以人口统计学、付款方、地理位置、患者严重程度、入院月份、年份以及入院月份的平均温度为自变量,建立模型来评估 UTI 诊断的可能性。我们发现,在控制患者因素和入院月份后,UTI 诊断的可能性随着温度的升高呈剂量依赖性增加。例如,与平均温度为 5-7.5°C 的月份相比,平均温度为 27.5-30°C 的月份的住院患者,其 UTI 主要诊断的可能性要高出 20%。然而,在平均温度极高(超过 30°C)的月份,UTI 住院的可能性会降低,这可能是由于行为发生了变化。因此,从人群水平来看,与 UTI 相关的住院治疗与温暖的天气有关。