Long-term catheterization linked to higher comorbidity, UTIs in community-dwelling adults

  • BMJ Open
  • 19 Jun 2019

  • International Clinical Digest
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Takeaway
  • Community-dwelling adults with long-term urinary catheterization (LTUC) are more likely to be older men with higher Charlson Comorbidity Index (CCI) scores, recent hospitalization with urinary catheters, and urinary tract infections (UTIs) requiring antibiotics.

Why this matters

  • Understanding the clinical characteristics and potential harms associated with LTUC in older community-dwelling adults may help reduce inappropriate use outside of acute care hospital settings.

Study design

  • Researchers analyzed medical and long-term care insurance claims for patients aged ≥75 years without ureteral stents or suprapubic catheters (n=32,617; 143 with LTUC).
  • Funding: Japan Agency for Medical Research and Development; Japanese Ministry of Health, Labor and Welfare.

Key results

  • Factors independently associated with LTUC (all P=.001) included (aORs; 95% CIs):
    • Male sex: 3.29 (2.27-4.76);
    • Older age:
      • 3.26 (1.99-5.34) for 82-86 years, and 
      • 3.85 (2.20-6.72) for ≥87 years;
    • Higher comorbidity score: 2.80 (1.81-4.34) for CCI ≥3; and
    • Recent history of hospitalization with urinary catheters: 2.46 (1.54-3.92).
  • LTUC was independently associated with the incidence of UTI, even after adjusting for confounding factors (adjusted rate ratio, 2.58; 95% CI, 1.68-3.96; P<.001>

Limitations

  • The small number of patients with LTUC limited statistical power.