Leaving in urinary catheter at discharge is linked to higher mortality in older patients with diabetes

  • Perluk T & al.
  • Eur Geriatr Med
  • 8 Jan 2021

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • A urinary catheter inserted during hospitalization but not removed at discharge is associated with high 1-year mortality in older adults (age ≥65 years) with diabetes and urinary retention.
  • Leaving the catheter in is a common practice.

Why this matters

  • Diabetic voiding dysfunction (“diabetic cystopathy”) affects >50% of older adults with diabetes.

Study design

  • Retrospective study including 327 consecutive older adults with urinary retention who had a catheter inserted during hospitalization. 
  • 42.5% (n=139) had diabetes.
  • Funding: None disclosed.

Key results

  • Most in both groups were discharged with the catheter in place (66.2% with diabetes vs 75.5% without; P=.082).
  • Overall, 38.8% with diabetes and 27.7% without died within 1 year of discharge:
    • OR: 1.66 (P=.042).
  • Among those with diabetes, 1-year mortality was significantly higher with a catheter at discharge vs without:
    • 48.9% vs 19.1%.
    • OR, 4.04 (P=.001).
  • No 1-year mortality difference by catheter at discharge in those without diabetes (26.8% vs 30.4%; OR, 0.83; P=.705).
  • After adjustments, 1-year mortality was independently associated (HRs) with:
    • Catheter at discharge: 2.56 (P=.019). 
    • Age: 1.04 (P=.021). 
    • Cancer: 2.72 (P=.007).  

Limitations

  • Small cohort.
  • Retrospective.
  • No data on variables such as nutritional/functional status, diabetes control/duration, or out-of-hospital catheter removal.
  • No controls without a catheter.