Objective: Urinary catheterization is associated with urinary tract infection, a common complication of stroke. We aimed to investigate the incidence and risk factors associated with urinary catheterization following acute stroke, and its impact on stroke outcome.
Method: We prospectively studied a cohort of 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 Foley catheter insertion over time, and Cox proportional hazards regression analysis to evaluate the independent predictors. The impact of urinary catheterization on poor stroke outcome (modified Rankin Scale >2 or dead) at 3 months was analyzed by logistic regression.
Results: Of 2789 study patients, 761 (27%) received Foley catheter insertion. Most urinary catheterization was carried out within two days of admission, with estimated cumulative incidence of 23% (95% CI, 22% to 25%) at 2 days, and 27% (25% to 29%) at 7 days. Predictors of urinary catheterization were advanced age (HR 1.01 per year; 95% CI, 1.00-1.01), increased National Institutes of Health Stroke Scale score (HR 1.08 per point; 1.07-1.09), and hemorrhagic (versus ischemic) stroke (HR 2.03; 1.69-2.44), after adjustment for gender, diabetes mellitus and previous stroke/transient ischemic attack. The influence of urinary catheterization on poor outcome at 3 months remained significant (OR 2.43; 1.65-3.58) after adjustment for relevant covariates.
Conclusion: Urinary catheterization was common among hospitalized acute stroke patients, and associated with poor outcome at 3 months. Judicious use of urinary catheter in acute stroke patients is crucial to improve quality of care.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0822111-220253 |
| Date | 22 August 2011 |
| Creators | Wu, Chun-Hsien |
| Contributors | Ying-Chun Li, Mei-Chiun Tseng, Huey-Juan Lin |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0822111-220253 |
| Rights | unrestricted, Copyright information available at source archive |
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