Failed Removal of Indwelling Urinary Catheters in Patients With Acute Stroke: Incidence and Risk Factors

Abstract

III.

Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: a probabilistic modelling study

“…These include precise implementation costs and potential negative impacts on patient quality of life (e.g. inappropriate catheter removal resulting in re-insertion, urogenital trauma and increased infection risk) [41]. Owing to a lack of relevant trial data, as well as the context specificity, multimodal nature and relative intangibility of catheter prevention, estimation of intervention costs was deemed out of scope.…”

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“…Urinary retentions were common in post-stroke patients with an incidence from 19-47% and indwelling urinary catheters were usually necessary [1][2][3]. Catheter-associated urinary tract infections (CAUTIs) were a prevalent hospital-acquired infection at intensive care units (ICUs), causing higher costs, longer stays, and patient morbidity [4,5].…”

“…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].…”