The impact of urine output trajectory on clinical outcomes in female patients with genitourinary infections in the intensive care unit.

Genitourinary infections are common in female intensive care unit patients and are associated with acute kidney injury and sepsis, often becoming life-threatening. Although urine volume correlates with these adverse outcomes, the prognostic value of dynamic urine output trajectories remains unclear. This study investigates the relationship between early urine output trajectories and clinical outcomes in female with genitourinary infections. A retrospective cohort of 1289 patients were analyzed. Latent class growth modeling identified distinct urine output trajectories in the first 3 days after intensive care unit admission. The primary endpoint was 28-day mortality, and the secondary outcome was the incidence of acute kidney injury. Four trajectory classes were identified: Class 1-persistently low (65.7%), Class 2-high-to-low (13.7%), Class 3-persistently high (4.0%), and Class 4-low-to-high (16.7%). In multivariable analysis, compared to Class 4, the 28-day mortality risk showed a graded increase with hazard ratio of 4.329 for Class 1, 3.477 for Class 2, and 2.081 for Class 3. Additionally, Class 1 was associated with a significantly higher incidence of acute kidney injury compared to Class 4. The trajectory of urine output changes in female patients with genitourinary infections is a potential variable in predicting mortality and acute kidney injury outcomes.