Does a time threshold exist for bladder repair after which outcomes worsen? A Trauma Quality Improvement Program study

Kuo, Yu-Chi; Li, Pei‐Hua; Hsu, Ting-An; Fu, Chih-Yuan; Bajani, Francesco; Mis, Justin; Poulakidas, Stathis; Bokhari, Faran

doi:10.1016/j.surg.2022.12.025

Cited by 1 publication

(4 citation statements)

References 14 publications

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“…Among these patients, an increased duration of hours to bladder repair did not significantly raise the likelihood of infection (p = 0.436) (Supplementary Table 4). (These analyses mirrored our previous report, and therefore, the tables have been submitted as supplementary material) [7].…”

Section: Resultssupporting

confidence: 80%

“…In this study, we aimed to validate a previously published result using a different study cohort and design [7]. The importance of validation lies in the ability to replicate findings and confirm their generalizability across various populations and contexts.…”

Section: Discussionmentioning

confidence: 90%

“…A previous report addressing a time threshold for bladder repair, after which outcomes worsen, was published using the Trauma Quality Improvement Program [7]. An increased infection rate and a longer hospital length of stay (LOS) were observed in bladder injury patients who underwent surgical repair more than 24 h after arrival at the emergency department (ED).…”

Section: Introductionmentioning

confidence: 99%

“…Compared with contents from other parts of the gastrointestinal tract, urine is typically aseptic, meaning it is free of bacteria and other infectious agents under normal conditions [6]. However, delayed surgical intervention for bladder injuries can lead to an increased risk of infection, as prolonged exposure of damaged tissue to urine may facilitate the growth of pathogenic microorganisms [7]. Furthermore, when the integrity of the bladder is compromised, urine can infiltrate the surrounding tissues, creating an environment conducive to bacterial colonization, which ultimately leads to infection [8].…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Twenty‐Four‐Hour Threshold for Bladder Repair: Impact on Infection Rates Using the National Trauma Data Bank

Kuo,

Chien,

et al. 2023

World j. surg.

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Purpose This study aimed to validate the previously reported association between delayed bladder repair and increased infection rates using the National Trauma Data Bank (NTDB). Methods Bladder injury patients with bladder repair in the NTDB from 2013 to 2015 were included. Propensity score matching (PSM) was used to compare mortality, infection rates, and hospital length of stay (LOS) between patients who underwent bladder repair within 24 h and those who underwent repair after 24 h. Linear regression and multivariate logistic regression analyses were also performed. Results A total of 1658 patients were included in the study. Patients who underwent bladder repair after 24 h had significantly higher infection rates (5.4% vs. 1.2%, p = 0.032) and longer hospital LOS (17.1 vs. 14.0 days, p = 0.032) compared to those who underwent repair within 24 h after a well-balanced 1:1 PSM (N = 166). Linear regression analysis showed a positive correlation between time to bladder repair and hospital LOS for patients who underwent repair after 24 h (B-value = 0.093, p = 0.034). Multivariate logistic regression analysis indicated that bladder repair after 24 h increased the risk of infection (odds = 3.162, p = 0.018). Subset analyses were performed on patients who underwent bladder repairs within 24 h and were used as a control group. These analyses showed that the time to bladder repair did not significantly worsen outcomes. Conclusions Delayed bladder repair beyond 24 h increases the risk of infection and prolongs hospital stays. Timely diagnosis and surgical intervention remain crucial for minimizing complications in bladder injury patients.

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Section: Resultssupporting

confidence: 80%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%