Analysis of the Failure of Removal of the Urinary Catheter for Patients With Intracerebral Hemorrhage Postoperatively

Abstract

Background: We conducted this study to assess the value of clinically relevant data for predicting the failure of removing urinary catheters among patients with intracerebral hemorrhage postoperatively. Materials and Methods: We retrospectively analyzed the medical records of all patients with intracerebral hemorrhage who underwent surgery for removal of intracerebral hematoma between January 2014 and December 2019, all of whom retained their urinary catheter. The patients were classified into 2 groups. Group A included patients who underwent successful removal of the catheter while group B included patients who underwent a failed removal. Univariate analysis was performed to determine the relationship between the failure of catheter removal and the patients’ preoperative clinical characteristics. Independent prognostic predictors were identified using multivariate analyses. Results: The site of intracerebral hematoma (P=0.004), volume of hematoma (P<0.001), intraventricular hemorrhage (P<0.001), admitted Glasgow Coma Scale (GCS) (P<0.001), GCS before urinary catheter removal (P<0.001), smoking (P=0.011), herniation (P<0.001), urine protein (P=0.013), creatinine (P=0.037), and timing of urinary catheter removal (P<0.001) were significantly different among the 2 groups. Multiple logistical regression analysis indicated that GCS before urinary catheter removal (odds ratio=1.171; 95% confidence interval=1.050-1.306; P=0.005) and timing for urinary catheter removal (odds ratio=0.962; 95% confidence interval=0.944-0.981; P<0.001) were associated with failure of urinary catheter removal. Conclusions: This study demonstrated that GCS before urinary catheter removal and the timing of urinary catheter removal are independent factors associated with failure of urinary catheter removal among patients with intracerebral hemorrhage.

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“…Overall, there was a 22.7% reduction in the CAUTI by implementing this program [8]. In patients with acute stroke, the timing of removal of urinary catheters (UCs) varied significantly, ranging from 3.8 days to 18 days [9,10]. Delayed removal of UCs can increase the incidence of CAUTI.…”

“…Delayed removal of UCs can increase the incidence of CAUTI. Several risk factors contribute to the failure of timely UC removal, including lower body mass index, benign prostatic hypertrophy, hemorrhagic stroke, lower levels of physical function, cognitive impairment, and diabetes mellitus (DM) [1,[9][10][11][12]. Neurosurgeons often refrained from UCs in patients with impaired consciousness due to concerns that urine retention could negatively impact postoperative outcomes by increasing intracranial pressure (IICP).…”

“…The decision surrounding UC removal posed a challenge in the neurological intensive care units (NICUs). The implementation of the Nursing-driven circle strategy (NDS) and bladder sonography scan protocol (BSP) were used to reduce the incidence of CAUTI has been carried out [1,13]. In our hospital's intensive care unit (ICU), the hospital information system (HIS) reminded the removal of UCs on day five has been automatic since 2002 [14].…”

Does Consciousness Level Determine the Timing of Successful Removal of Urinary Catheters at Neurosurgery Intensive Care Unit – Implication to Nosocomial Infection Prevention

“…Delayed removal of UCs can increase the incidence of CAUTI. Several risk factors contribute to the failure of timely UC removal, including lower body mass index, benign prostatic hypertrophy, hemorrhagic stroke, lower levels of physical function, cognitive impairment, and diabetes mellitus (DM) [1,[9][10][11][12]. Neurosurgeons often refrained from UCs in patients with impaired consciousness due to concerns that urine retention could negatively impact post-operative outcomes by increasing intracranial pressure (IICP).…”

“…Overall, there was a 22.7% reduction in the CAUTI by implementing this program [8]. In patients with acute stroke, the timing of removal of urinary catheters (UCs) varied signi cantly, ranging from 3.8 days to 18 days [9,10]. Delayed removal of UCs can increase the incidence of CAUTI.…”