New study highlights UTI risks in hospitalized Parkinson’s patients
Findings support early detection and careful catheter use in hospitals
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- UTIs are common in hospitalized Parkinson’s patients and are linked to longer stays and a slightly higher risk of delirium.
- Risk factors include urinary catheter use, age 65 and older, dementia, inter-facility transfer, and emergency admission.
- Prevention strategies include early UTI detection, careful catheter use, uninterrupted Parkinson’s therapy, and early rehabilitation.
Urinary tract infections (UTIs) are common among people hospitalized with Parkinson’s disease and are linked to longer hospital stays and a slightly higher risk of delirium, according to a retrospective analysis of 321,967 Parkinson’s-related hospitalizations from a large U.S. hospital database.
The findings highlight the need for targeted prevention strategies for hospitalized Parkinson’s patients, particularly careful urinary catheter use and early detection of infections.
The study, “Urinary Tract Infections in Hospitalized Patients with Parkinson’s Disease: Risk Factors and Outcomes,” was published in Movement Disorders Clinical Practice.
Why UTIs may pose added risks in Parkinson’s
UTIs are among the most common infections in older adults and are a leading cause of bloodstream infections. In frail individuals, they often result in hospitalization and can trigger declines in physical and cognitive function. UTIs are also well recognized as a major trigger of delirium.
People with Parkinson’s disease appear to face an even greater risk. Prior studies suggest they may be about twice as likely to be hospitalized for UTIs compared with people without Parkinson’s.
Although UTIs are generally more common in women and become more frequent with age, this sex difference may be less pronounced in Parkinson’s. This suggests the disease itself may increase vulnerability. Possible contributing factors include autonomic nervous system dysfunction (which can affect bladder control), urinary catheter use, and cognitive impairment. However, large-scale data focused specifically on hospitalized Parkinson’s patients have been limited.
To address this gap, researchers analyzed risk factors for UTIs in hospitalized people with Parkinson’s and evaluated how infections were associated with length of stay, delirium, and in-hospital death.
The team conducted a retrospective study of hospitalized adults ages 50 and older with Parkinson’s disease using data from the PINC-AI Healthcare Database, a large U.S. hospital database that captures patient demographics, diagnoses, treatments, and hospital resource use. The analysis covered hospitalizations between November 2017 and June 2023.
To improve accuracy, the researchers excluded hospital stays longer than 60 days and duplicate admissions. These were considered extreme outliers that might reflect long-term or non-acute care rather than typical hospitalizations and could skew length-of-stay analyses.
Large U.S. database study examines hospitalizations
In total, the analysis included 321,967 hospitalizations involving people with Parkinson’s disease, and 60,988 of those admissions involved a UTI.
A multivariate analysis, which accounts for multiple factors at the same time, identified several independent risk factors for UTI. These included urinary catheter use, inter-facility transfer, age 65 and older, dementia, and emergency or urgent admission. Male sex was associated with a lower likelihood of UTI.
Patients with UTI had a longer median hospital stay than those without infection — five days compared with four days. Among UTI-related admissions, inter-facility transfer and sepsis were associated with even longer hospital stays.
UTI was also independently associated with a slightly increased risk of delirium during hospitalization. However, although crude survival differed by UTI status, adjusted analyses did not show higher in-hospital mortality directly attributable to UTI. Instead, factors such as older age, chronic heart failure, cancer, coronary artery disease, and sepsis were associated with increased mortality risk.
Overall, the findings support targeted interventions for hospitalized Parkinson’s patients, including “early UTI detection, strict catheter avoidance, uninterrupted dopaminergic therapy, and systematic early rehabilitation,” the researchers concluded.
