Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers

Net, P; Karnycheff, F.; Vasse, Marc; Bourdain, Frédéric; Bonan, Brigitte; Lapergue, Bertrand

doi:10.1016/j.neurol.2017.06.029

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…Overall, approximately 1 in 10 stroke patients in our study had an IUC inserted, but the frequency was higher in the elderly and those with a history of heart disease, greater baseline neurological deficit, and ICH as the cause. As such, the lower overall frequency of IUC in our study than reported in registries (20%–30%) 4,5,10 may reflect the selective nature of the clinical trial population which included patients with predominantly mild to moderate neurological severity, despite the pragmatic design and broad inclusion criteria. Yet, our data are consistent with others in showing an association of IUC with increasing age and stroke severity.…”

Section: Discussionmentioning

confidence: 64%

Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

Ouyang

Billot

Song

et al. 2020

International Journal of Stroke

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Total Word Count: 4173 (Abstract 244; Main 2083) 2 Brief title: Urinary catheterization and stroke outcome Abstract Background: An indwelling urinary catheter (IUC) is often inserted to manage bladder dysfunction but its impact on prognosis is uncertain. We aimed to determine the association of IUC use on clinical outcomes after acute stroke in the international, multi-center, cluster crossover, Head Positioning in Acute Stroke Trial (HeadPoST). Methods: Data were analyzed on HeadPoST participants (n=11,093) randomly allocated to the lying-flat or sitting-up head position. Binomial, logistic regression, hierarchical mixed models were used to determine associations of early insertion of IUC within 7 days postrandomization and outcomes of death or disability (defined as 'poor outcome', scores 3-6 on the modified Rankin scale) and any urinary tract infection (UTI) at 90 days with adjustment of baseline and post-randomization management covariates.Results: Overall, 1167 (12%) patients had an IUC, but the frequency and duration of use varied widely across patients in different regions. IUC use was more frequent in older patients, and those with vascular comorbidity, greater initial neurological impairment (on the National Institutes of Health stroke scale), and intracerebral hemorrhage as the underlying stroke type. IUC use was independently associated with poor outcome (adjusted odds ratio[aOR] 1.40, 95% confidence interval [CI] 1.13-1.74), but not with UTI after adjustment for antibiotic treatment and stroke severity at hospital separation (aOR 1.13, 95% CI 0.59-2.18). The number exposed to IUC for poor outcome was 13.Conclusions: IUC use is associated with a poor outcome after acute stroke. Further studies are required to inform appropriate use of IUC.

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Section: Discussionmentioning

confidence: 64%

Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

Ouyang

Billot

Song

et al. 2020

International Journal of Stroke

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“…As a result, patients suffer more pains and difficulties in treatment. The risk of urinary tract infection (Mayumi et al 2019;Net et al 2018) will rise, disadvantaging the prognosis. As a common treatment of UR, indwelling catheter may lead to urinary tract infection while extubation difficulties are expected in some patients.…”

Section: Discussionmentioning

confidence: 99%

Low-frequency Electrical Stimulation Combined with Preventative Pelvic Floor Muscle Exercises and Knowledge-attitude-practice Model in Women with Urinary Retention after a Pelvic Surgery

Liu¹,

Guo²,

Kang³

et al. 2021

JSM

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This study was to explore the efficacy of low-frequency electrical stimulation (LFES) combined with preventative pelvic floor muscle exercises (PPFME) and knowledge-attitude-practice model (KAP model) in women with urinary retention (UR) after a pelvic surgery and the effect on quality of life (QOL). The clinical data of 153 women hospitalized with UR after a pelvic surgery from January 2015 to June 2019 were retrospectively analyzed and divided into the Control Group (CG, n=45, LFES+PPFME) and the Study Group (SG, n=108, LFES+PPFME+KAP model) according to the different treatment methods. Following indicators were compared between the two groups: clinical efficacy, time to first urination, urine output, rate of extubation in 3D, rate of repeated intubation, urodynamic indicators before and after treatment, postvoid residual (PVR), bladder compliance (BC), maximal flow rate (Q-max), pressure of detrusor at Pdet-Q-max (Pdet-Q-max), changes in QOL, incidence of urinary tract infection, and length of stay (LOS). Compared to CG, SG showed higher overall response rate (ORR) and rate of extubation in 3D, shorter time to first urination, higher urine output, lower rate of repeated intubation and incidence of urinary tract infection, and shorter LOS (P<0.05); both groups achieved improvements in urodynamic indicators and QOL score after treatment (P<0.05); the urodynamic indicators and QOL score in SG were better than the CG’s (P<0.05). LFES combined with PPFME and KAP model is effective in treating women with UR after a pelvic surgery by efficaciously improving patients’ urination and QOL.

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“…Inclusion criteria were as follows: (1) diagnosed with cerebral hemorrhage (including subarachnoid hemorrhage) by CT in accordance with the fourth national diagnostic criteria for cerebrovascular disease of 1995 in China [14]; (2) age ≥ 50 years; (3) 1 week ≤ course ≤ 12 weeks; (4) agreed to undergo a blood routine, biochemical analysis, urine routine, urine culture, and other examinations after admission; (5) signed the rehabilitation informed consent form.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Urinary tract infection (UTI) is not only a significant complication but also a potential risk factor for poor prognosis of stroke. It has been reported that the incidence of UTI in stroke patients is 14.2-34.7% [1][2][3]. Intracranial cerebral hemorrhage (ICH) is the most severe subtype of stroke [4,5], with a mortality rate of 29% within one year of onset [6], and UTI-induced death accounts for about 20% of total ICH deaths [7].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study on Risk Factors for Urinary Tract Infection in Patients with Intracranial Cerebral Hemorrhage

et al. 2020

BioMed Research International

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Objective. This study aimed to explore the risk factors of urinary tract infection (UTI) in patients with intracranial cerebral hemorrhage (ICH). Design. This is a retrospective study, and a total of 77 patients with ICH consecutively admitted to the First Affiliated Hospital of USTC (Anhui Provincial Hospital, Hefei, China) during the period of August 2015 to August 2017 were included. The patients were divided into an UTI group (24 cases) and a non-UTI group (53 cases); patients with UTI were diagnosed according to clinical manifestations, recent urinary routines, and urine culture results. The following information in these two groups was recorded: age, sex, course of disease, side of paralysis, location and type of cerebral hemorrhage, disturbance of consciousness or not, the Brunnstrom stage of paralysed lower limbs, number of basic diseases, whether there were complications (tracheotomy, retention catheterization, pulmonary infection, pressure sore, deep venous thrombosis, etc.), whether rehabilitation interventions were conducted, blood routine, biochemistry index, DIC complete set, urine routine, and urine culture data. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors of UTI in patients with ICH. Results. Univariate analysis showed that age, side of paralysis, disturbance of consciousness, the Brunnstrom stage of lower limbs, tracheotomies, retention catheterization, pulmonary infection, leukocyte count, neutrophil proportion, sodium, uric acid, D-dimer, and fibrinogen may be related to UTI in patients with ICH (P<0.05). Regression analysis showed that age (OR (95% CI) = 1.207 (1.022–1.424), P=0.026), right-sided paralysis (OR (95% CI) = 0.20 (0.001–0.650), P=0.028), and D-dimer (OR (95% CI) = 1.403 (1.003–1.961), P=0.048) were associated with UTI in ICH patients. Conclusions. Increased age and high D-dimer are independent risk factors for UTI in patients with ICH, while right-sided paralysis is a protective factor for UTI in patients with ICH.

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Urinary tract infection after acute stroke: Impact of indwelling urinary catheterization and assessment of catheter-use practices in French stroke centers

Cited by 14 publications

References 19 publications

Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

Low-frequency Electrical Stimulation Combined with Preventative Pelvic Floor Muscle Exercises and Knowledge-attitude-practice Model in Women with Urinary Retention after a Pelvic Surgery

A Retrospective Study on Risk Factors for Urinary Tract Infection in Patients with Intracranial Cerebral Hemorrhage

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