Indwelling urinary catheterization after acute stroke

doi:10.1002/nau.22317

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標題:	Indwelling urinary catheterization after acute stroke
作者:	Wu, Chun-Hsien Tseng, Mei-Chiun Chen, Yu-Wei Sung, Sheng-Feng Yeh, Poh-Shiow Lin, Huey-Juan
貢獻者:	醫務管理系
關鍵字:	Acute Stroke Indwelling Urinary Catheterization Outcome Risk Factors
日期:	2013-06
上傳時間:	2014-05-26 10:46:59 (UTC+8)
出版者:	Wiley-Blackwell
摘要:	Aims Prolonged indwelling urinary catheterization (IUC) increases risk of urinary tract infection. We aimed to investigate the incidence and risk factors associated with IUC following acute stroke, and its impact on stroke outcome. Methods We prospectively enrolled stroke patients hospitalized within 10 days after onset from August 2006 to December 2008. Kaplan-Meier method was used to estimate the cumulative incidence of IUC, and Cox regression analysis to evaluate the independent predictors. The impact of IUC on poor outcome (modified Rankin Scale >2 or dead) at 3 months was studied by logistic regression. Results Of 2,803 patients, 697 (25%) received indwelling urinary catheters. Catheterization was carried out mostly within 1-2 days of admission (86%), with estimated cumulative incidence of 13% (95% confidence interval, 11-14%) at 2 days in patients with ischemic stroke (IS), and 57% (53-61%) in patients with intracerebral hemorrhage (ICH). In IS patients, IUC was significantly associated with increasing age, baseline stroke severity, and neurological deterioration. In ICH patients, stroke severity on admission was the only significant predictor after adjustment. We assessed the 3-month outcome in 2,388 patients, after excluding 177 (6%) dead at discharge, 164 (6%) without providing informed consent, and 74 (3%) lost to follow-up. IUC during acute hospitalization was significantly associated with unfavorable 3-month outcome after adjustment. Conclusions IUC was common in acute stroke care and associated with unfavorable outcome at 3 months. Whether judicious use of urinary catheters in acute stroke patients would improve outcomes may warrant further studies. Neurourol. Urodynam. 32: 480-485, 2013. (c) 2012 Wiley Periodicals, Inc.
關聯:	Neurourology And Urodynamics, v.32 n.5, pp.480-485
显示于类别:	[醫務管理系(所)] 期刊論文

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