Impact of Preoperative Urinary Tract Infection on Postoperative Outcomes in Plastic Surgery

Background: Urinary tract infections (UTIs) at the time of surgery have been associated with worse postoperative outcomes in various surgical specialties, but their impact in plastic surgery remains poorly understood. Methods: We analyzed National Surgical Quality Improvement Program data (2012–2023) for adult elective plastic surgery patients to determine the relationship between preoperative UTI and postoperative outcomes. Logistic regression estimated odds ratios adjusted for clinical covariates. Results: A total of 319,511 elective plastic surgery patients were analyzed, among whom 117 (0.04%) had a documented preoperative UTI. Preoperative UTI was associated with significantly worse outcomes. The incidence of postoperative wound infection was markedly higher in the UTI group, and multivariable logistic regression confirmed preoperative UTI as an independent predictor of surgical site infection with an adjusted odds ratio of 5.87 (95% confidence interval: 1.54–22.36, P = 0.009). Additionally, patients with UTIs had prolonged hospital stays (12.2 versus 1.3 d, P < 0.001), were more likely to return to the operating room (11.1% versus 3.7%, P < 0.001), and had a substantially higher 30-day mortality rate (4.3% versus 0.1%, P < 0.001). They were also more likely to require postdischarge care at a facility rather than returning home. Conclusions: Preoperative UTI, although infrequent, significantly increases postoperative complications in elective plastic surgery patients, including surgical site infections, mortality, and discharge to a care facility. These findings support more aggressive preoperative screening and the postponement of elective procedures until UTI resolution.