• Takahiro Higashibata, Takayuki Hisanaga, Shingo Hagiwara, Miho Shimokawa, Ritsuko Yabuki, Takuya Odagiri, Tetsuya Ito, Rena Kamura, Isseki Maeda, Kazuhiro Kosugi, Masanori Mori, Tatsuya Morita, Satoru Tsuneto, and Jun Hamano.
• Palliative Care Team, Department of General Medicine and Primary Care, University of Tsukuba Hospital, Tsukuba, Japan.
• Palliat Med. 2021 Apr 1; 35 (4): 799-805.

BackgroundStudies on the appropriate use of urinary catheters for cancer patients at the end of life are limited.AimTo clarify the differences among institutions in the prevalence of and indications for urinary catheterization of advanced cancer patients at palliative care units.DesignPre-planned secondary analysis of a multicenter, prospective cohort study; East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED).Setting/ParticipantsThis study enrolled consecutive advanced cancer patients admitted to palliative care units between January and December 2017. The final study group comprised 1212 patients from 21 institutions throughout Japan.ResultsOut of the 1212 patients, 380 (31.4%; 95% confidence interval, 28.7%-34.0%) underwent urinary catheterization during their palliative care unit stay, and the prevalence of urinary catheterization in patients who died at palliative care units by institution ranged from 0.0% to 55.4%. When the 21 participating institutions were equally divided into three groups according to the institutional prevalence of catheterization, patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation were more likely to be catheterized in institutions with a high prevalence of catheterization than in those with a low or moderate prevalence (p < 0.008, p = 0.008, and p < 0.008, respectively).ConclusionThis study revealed that the institutional prevalence of urinary catheterization in advanced cancer patients at palliative care units widely varied. Further studies are needed to establish the appropriate use of urinary catheters, especially in patients with difficulty in moving safely, exhaustion on movement, and restlessness or agitation.

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