Tal Perluk1,2, Amir Dagan3,4, Michael Swartzon5, Asnat Groutz2,6, Dan Justo7,8. 1. Pulmonology Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. 2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3. Internal Medicine B, Assuta Medical Center, Ashdod, Israel. 4. Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel. 5. Department of Humanities, Health and Society, Florida International University College of Medicine, Miami, FL, USA. 6. Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. 7. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. dan.justo@sheba.health.gov.il. 8. Geriatrics Division, Sheba Medical Center, 5265601, Tel-Hashomer, Israel. dan.justo@sheba.health.gov.il.
Abstract
PURPOSE: We have studied, in diabetic older adults with urinary retention (UR), whether a urinary catheter (UC) inserted during hospitalization but not removed is associated with 1-year mortality. METHODS: A retrospective study included 327 consecutive older adults (age ≥ 65 years; median age 83 years; 57.8% males) with UR in whom a UC was inserted during hospitalization: 139 (42.5%) diabetics and 188 (57.5%) nondiabetics. UC removal rates during hospitalization and 1-year mortality rates were studied in both groups. Cox regression analysis was used to assess whether a UC inserted during hospitalization but not removed was independently associated with 1-year mortality. RESULTS: Most diabetic and non-diabetic patients left the hospital with a UC (66.2% vs. 75.5%; p = 0.082). Overall, 54 (38.8%) diabetic patients and 52 (27.7%) nondiabetic patients died one year later (OR 1.66; 95% CI 1.04-2.65; p = 0.042). Diabetic patients with a UC at discharge day had significantly higher 1-year mortality rates relative to diabetic patients without a UC (48.9% vs. 19.1%; OR 4.04; 95% CI 1.75-9.30; p = 0.001), while in nondiabetic patients there was no significant difference in 1-year mortality rates between patients with or without a UC at discharge day (26.8% vs. 30.4%; p = 0.705). Cox regression analysis showed that only in diabetic patients a UC not removed was independently associated with 1-year mortality (HR 2.56; 95% CI 1.16-5.64; p = 0.019). CONCLUSION: A UC inserted but not removed in diabetic older adults with UR is associated with 1-year mortality. Removing a UC and its association with mortality should be studied prospectively in this population.
PURPOSE: We have studied, in diabetic older adults with urinary retention (UR), whether a urinary catheter (UC) inserted during hospitalization but not removed is associated with 1-year mortality. METHODS: A retrospective study included 327 consecutive older adults (age ≥ 65 years; median age 83 years; 57.8% males) with UR in whom a UC was inserted during hospitalization: 139 (42.5%) diabetics and 188 (57.5%) nondiabetics. UC removal rates during hospitalization and 1-year mortality rates were studied in both groups. Cox regression analysis was used to assess whether a UC inserted during hospitalization but not removed was independently associated with 1-year mortality. RESULTS: Most diabetic and non-diabeticpatients left the hospital with a UC (66.2% vs. 75.5%; p = 0.082). Overall, 54 (38.8%) diabeticpatients and 52 (27.7%) nondiabetic patientsdied one year later (OR 1.66; 95% CI 1.04-2.65; p = 0.042). Diabeticpatients with a UC at discharge day had significantly higher 1-year mortality rates relative to diabeticpatients without a UC (48.9% vs. 19.1%; OR 4.04; 95% CI 1.75-9.30; p = 0.001), while in nondiabetic patients there was no significant difference in 1-year mortality rates between patients with or without a UC at discharge day (26.8% vs. 30.4%; p = 0.705). Cox regression analysis showed that only in diabeticpatients a UC not removed was independently associated with 1-year mortality (HR 2.56; 95% CI 1.16-5.64; p = 0.019). CONCLUSION: A UC inserted but not removed in diabetic older adults with UR is associated with 1-year mortality. Removing a UC and its association with mortality should be studied prospectively in this population.