Rates of hospitalization for urinary tract infections among medicaid-insured individuals by spina bifida status, Tennessee 2005-2013.

The study used administrative claims and vital records, not chart review, so spina bifida status, UTI hospitalizations, and chronic conditions could be misclassified. People with spina bifida may be screened for asymptomatic bacteriuria during a hospital stay, which could be coded as a UTI and make the association with spina bifida look stronger than it is. The cohort included only Tennessee Medicaid residents in counties representing about 60% of the state population, so results may not apply to rural areas, non-Medicaid populations, or other states. Pregnant people were excluded and the study only included people younger than 65, so it does not describe those groups. Race was recorded, but ethnicity was not. Other unmeasured factors might have influenced the rates. In the chronic-condition-free subgroup, some estimates were based on very small numbers, such as 5 of 99 infants with spina bifida.

No author conflict-of-interest statement is included in the supplied text. The article is tagged as supported by U.S. government and Public Health Service research support.

Do not read the higher UTI hospitalization rate as proof that spina bifida causes hospitalization or that a clinical intervention would reduce it. The study is observational, uses Medicaid claims codes, and the authors warn that asymptomatic bacteriuria could be misclassified as UTI, especially in people with spina bifida.