The Relationship of Indwelling Urinary Catheters to Death, Length of Hospital Stay, Functional Decline, and Nursing Home Admission in Hospitalized Older Medical Patients

  1. Jayna M. Holroyd-Leduc MD,
  2. Saunak Sen PhD,
  3. Dan Bertenthal MS,
  4. Laura P. Sands PhD,
  5. Robert M. Palmer MD, MPH,
  6. Denise M. Kresevic PhD,
  7. Kenneth E. Covinsky MD, MPH,
  8. C. Seth Landefeld MD

Article first published online: 18 JAN 2007

DOI: 10.1111/j.1532-5415.2007.01064.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 55, Issue 2, pages 227–233, February 2007

Additional Information

How to Cite

Holroyd-Leduc, J. M., Sen, S., Bertenthal, D., Sands, L. P., Palmer, R. M., Kresevic, D. M., Covinsky, K. E. and Seth Landefeld, C. (2007), The Relationship of Indwelling Urinary Catheters to Death, Length of Hospital Stay, Functional Decline, and Nursing Home Admission in Hospitalized Older Medical Patients. Journal of the American Geriatrics Society, 55: 227–233. doi: 10.1111/j.1532-5415.2007.01064.x

Author Information

  1. From the *Department of Medicine, University of Calgary, Canada†Division of Geriatrics, San Francisco Veterans Affairs Medical Center and University of California, San Francisco, California‡School of Nursing and Center for Aging and the Life Course, Purdue University, West Lafayette, Indiana§Section of Geriatric Medicine, Cleveland Clinic, Cleveland, Ohio∥Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OhioDepartment of Medical-Surgical Nursing University Hospitals of Cleveland, Cleveland, Ohio

*Address correspondence to Jayna M. Holroyd-Leduc, Foothills Medical Center, Room 707, 7th Floor North Tower, 1403–29th Street NW, Calgary, Alberta, Canada T2N 2T9. E-mail: jayna.holroyd-leduc@calgaryhealthregion.ca

Publication History

  1. Issue published online: 18 JAN 2007
  2. Article first published online: 18 JAN 2007

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Keywords:

  • urinary catheters;
  • hospitalized older patients;
  • mortality;
  • morbidity

OBJECTIVES: To determine the association between indwelling urinary catheterization without a specific medical indication and adverse outcomes.

DESIGN: Prospective cohort.

SETTING: General medical inpatient services at a teaching hospital.

PARTICIPANTS: Five hundred thirty-five patients aged 70 and older admitted without a specific medical indication for urinary catheterization.

INTERVENTION: Indwelling urinary catheterization within 48 hours of admission.

MEASUREMENTS: Death, length of hospital stay, decline in ability to perform activities of daily living (ADLs), and new admission to a nursing home.

RESULTS: Indwelling urinary catheters were placed in 76 of the 535 (14%) patients without a specific medical indication. Catheterized patients were more likely to die in the hospital (6.6% vs 1.5% of those not catheterized, P=.006) and within 90 days of hospital discharge (25% vs 10.5%, P<.001); the greater risk of death with catheterization persisted in a propensity-matched analysis (hazard ratio (HR)=2.42, 95% confidence interval (CI)=1.04–5.65). Catheterized patients also had longer lengths of hospital stay (median, 6 days vs 4 days; P=.001); this association persisted in a propensity-matched analysis (HR=1.46, 95% CI=1.03–2.08). Catheterization was not associated (P>.05) with decline in ADL function or with admission to a nursing home.

CONCLUSION: In this cohort of older patients, urinary catheterization without a specific medical indication was associated with greater risk of death and longer hospital stay.

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