• Heidi L Wald, Allen Ma, Dale W Bratzler, and Andrew M Kramer.
• Division of Health Care Policy and Research, University of Colorado Denver School of Medicine, 13611 E Colfax Ave, Ste 100, Aurora, CO 80011, USA. heidi.wald@uchsc.edu
• Arch Surg. 2008 Jun 1; 143 (6): 551-7.

ObjectivesTo describe the frequency and duration of perioperative catheter use and to determine the relationship between catheter use and postoperative outcomes.DesignRetrospective cohort study.SettingTwo thousand nine hundred sixty-five acute care US hospitals.PatientsMedicare inpatients (N = 35 904) undergoing major surgery (coronary artery bypass and other open-chest cardiac operations; vascular surgery; general abdominal colorectal surgery; or hip or knee total joint arthroplasty) in 2001. Main Outcome Measure Postoperative urinary tract infection.ResultsEighty-six percent of patients undergoing major operations had perioperative indwelling urinary catheters. Of these, 50% had catheters for longer than 2 days postoperatively. These patients were twice as likely to develop urinary tract infections than patients with catheterization of 2 days or less. In multivariate analyses, a postoperative catheterization longer than 2 days was associated with an increased likelihood of in-hospital urinary tract infection (hazard ratio, 1.21; 95% confidence interval [CI], 1.04-1.41) and 30-day mortality (parameter estimate, 0.54; 95% CI, 0.37-0.72) as well as a decreased likelihood of discharge to home (parameter estimate, - 0.57; 95% CI, - 0.64 to - 1.51).ConclusionsIndwelling urinary catheters are routinely in place longer than 2 days postoperatively and may result in excess nosocomial infections. The association with adverse outcomes makes postoperative catheter duration a reasonable target of infection control and surgical quality-improvement initiatives.

30 keywords...

hide…