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Arch Surg. 2008 Jun;143(6):551-7. doi: 10.1001/archsurg.143.6.551.

Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data.

Author information

1
Division of Health Care Policy and Research, University of Colorado Denver School of Medicine, 13611 E Colfax Ave, Ste 100, Aurora, CO 80011, USA. heidi.wald@uchsc.edu

Abstract

OBJECTIVES:

To describe the frequency and duration of perioperative catheter use and to determine the relationship between catheter use and postoperative outcomes.

DESIGN:

Retrospective cohort study.

SETTING:

Two thousand nine hundred sixty-five acute care US hospitals.

PATIENTS:

Medicare inpatients (N = 35 904) undergoing major surgery (coronary artery bypass and other open-chest cardiac operations; vascular surgery; general abdominal colorectal surgery; or hip or knee total joint arthroplasty) in 2001. Main Outcome Measure Postoperative urinary tract infection.

RESULTS:

Eighty-six percent of patients undergoing major operations had perioperative indwelling urinary catheters. Of these, 50% had catheters for longer than 2 days postoperatively. These patients were twice as likely to develop urinary tract infections than patients with catheterization of 2 days or less. In multivariate analyses, a postoperative catheterization longer than 2 days was associated with an increased likelihood of in-hospital urinary tract infection (hazard ratio, 1.21; 95% confidence interval [CI], 1.04-1.41) and 30-day mortality (parameter estimate, 0.54; 95% CI, 0.37-0.72) as well as a decreased likelihood of discharge to home (parameter estimate, - 0.57; 95% CI, - 0.64 to - 1.51).

CONCLUSIONS:

Indwelling urinary catheters are routinely in place longer than 2 days postoperatively and may result in excess nosocomial infections. The association with adverse outcomes makes postoperative catheter duration a reasonable target of infection control and surgical quality-improvement initiatives.

PMID:
18559747
DOI:
10.1001/archsurg.143.6.551
[Indexed for MEDLINE]

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