Routine Indwelling Urethral Catheterization in Acute Heart Failure Patients Is Associated With Increased Urinary Tract Complications Without Improved Heart Failure Outcomes

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  • Jang Albert Youngwoo
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center Division of Cardiovascular Medicine, Stanford University
  • O’Brien Connor
    Division of Cardiovascular Medicine, Stanford University
  • Chung Wook-Jin
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center
  • Oh Pyung Chun
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center
  • Yu Jongwook
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center
  • Lee Kyounghoon
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center
  • Kang Woong Chol
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center
  • Moon Jeonggeun
    Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center

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<p>Background:Indwelling urethral catheters (IUC) are routinely inserted for the purpose of monitoring urine output in patients with acute heart failure (AHF). The benefit of IUC in patients capable of complying with urine collection protocols is unclear, and IUC carry multiple risks. This study describes the impact of IUC on AHF treatment.</p><p>Methods and Results:A total of 540 records were retrospectively analyzed. After exclusion criteria were applied, 316 patients were propensity matched to establish groups of 100 AHF patients who either did (IUC(+)) or did not receive an IUC (IUC(−)) upon admission. Hospital length of stay (9 vs. 7 days), in-hospital urinary complications (24 vs. 5%), and 1-year urinary tract infection rate (17 vs. 6%; HR, 3.145; 95% CI: 1.240–7.978) were significantly higher in the IUC(+) group (P<0.05 for all). There were no differences in 30-day rehospitalization (6 vs. 6%; HR, 0.981; 95% CI: 0.318–3.058; P=0.986) or major adverse cardiac/cerebrovascular events at 1 year (37 vs. 32%, HR, 1.070; 95% CI: 0.636–1.799; P=0.798).</p><p>Conclusions:Based on this retrospective analysis, the routine use of IUC may increase length of stay and UTI complications in AHF patients without reducing the risk for major cardiovascular and cerebrovascular events or 30-day rehospitalization rate.</p>

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  • Circulation Journal

    Circulation Journal 82 (6), 1632-1639, 2018-05-25

    一般社団法人 日本循環器学会

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