Admission hyperglycemia increases risk of UTI in acute pancreatitis: a dose-response and PSM-based analysis.

PURPOSE: This study aimed to explore the relationship between admission hyperglycemia and urinary tract infections (UTIs) after admission in patients with acute pancreatitis (AP) by propensity score matching (PSM) analysis, expected to provide evidence support for admission blood glucose monitoring and management and prevention of UTIs in patients with AP. METHODS: We included 728 patients with AP. According to their admission blood glucose levels, patients were divided into hyperglycemia group and normoglycemia group, and conducted multiple logistic regression to assess the odds ratio and 95% confidence intervals for UTIs, then analyzed the odds changes after controlling confounding factors by PSM. In addition, to further explore the relationship between admission blood glucose and UTIs, we performed subgroup analysis to illustrate the dose-response relationship between admission blood glucose and UTIs. RESULTS: In the context of AP, patients in hyperglycemia group showed a higher rate of UTIs, both before PSM (28.4% vs. 7.9%, P < 0.001) and after PSM (18.7% vs. 8.3%, P < 0.001). Admission hyperglycemia was an independent risk factor for UTI in patients with AP, with an odds ratios of 4.49 (95% CI 1.91-10.55, P < 0.001) after multivariable regression and 2.51 (95% CI 1.22-5.19, P = 0.012) after PSM. Also, a clear dose-response relationship was observed between higher admission glucose level and UTI. CONCLUSION: Our study suggests that admission hyperglycemia increases the risk of UTI in patients with AP, and that there is a dose-response relationship between admission hyperglycemia and the risk of UTI. Enhanced monitoring and management of blood glucose on admission may reduce the risk of UTI and improve the prognosis of this vulnerable population.