Dirk De Ridder led the peer-review process as the Associate Editor responsible for this paper.
Original Clinical Article
Article first published online: 15 OCT 2012
Copyright © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 5, pages 480–485, June 2013
How to Cite
Wu, C.-H., Tseng, M.-C., Chen, Y.-W., Sung, S.-F., Yeh, P.-S. and Lin, H.-J. (2013), Indwelling urinary catheterization after acute stroke. Neurourol. Urodyn., 32: 480–485. doi: 10.1002/nau.22317
Conflict of interest: None.
- Issue published online: 18 JUN 2013
- Article first published online: 15 OCT 2012
- Manuscript Accepted: 23 AUG 2012
- Manuscript Received: 14 MAY 2012
- National Science Council. Grant Number: NSC100-2410-H-110-051
- Taiwan Stroke Registry, Department of Health, Taiwan, The Ministry of Education, Taiwan
- Dr. Chi-Chin Huang Stroke Foundation
- acute stroke;
- indwelling urinary catheterization;
- risk factors
Prolonged indwelling urinary catheterization (IUC) increases risk of urinary tract infection. We aimed to investigate the incidence and risk factors associated with IUC following acute stroke, and its impact on stroke outcome.
We prospectively enrolled stroke patients hospitalized within 10 days after onset from August 2006 to December 2008. Kaplan–Meier method was used to estimate the cumulative incidence of IUC, and Cox regression analysis to evaluate the independent predictors. The impact of IUC on poor outcome (modified Rankin Scale >2 or dead) at 3 months was studied by logistic regression.
Of 2,803 patients, 697 (25%) received indwelling urinary catheters. Catheterization was carried out mostly within 1–2 days of admission (86%), with estimated cumulative incidence of 13% (95% confidence interval, 11–14%) at 2 days in patients with ischemic stroke (IS), and 57% (53–61%) in patients with intracerebral hemorrhage (ICH). In IS patients, IUC was significantly associated with increasing age, baseline stroke severity, and neurological deterioration. In ICH patients, stroke severity on admission was the only significant predictor after adjustment. We assessed the 3-month outcome in 2,388 patients, after excluding 177 (6%) dead at discharge, 164 (6%) without providing informed consent, and 74 (3%) lost to follow-up. IUC during acute hospitalization was significantly associated with unfavorable 3-month outcome after adjustment.
IUC was common in acute stroke care and associated with unfavorable outcome at 3 months. Whether judicious use of urinary catheters in acute stroke patients would improve outcomes may warrant further studies. Neurourol. Urodynam. 32: 480–485, 2013. © 2012 Wiley Periodicals, Inc.