Aims
Indwelling urinary catheter (IDC) use is common in hip fracture patients, and there are limited guidelines on its use and management. The primary aim was to assess whether IDC duration affected trial of void (TOV) outcomes in adults ≥65 years old who underwent hip fracture surgery. The secondary aim was to analyse eleven other variables for association with TOV outcome, as well as investigate catheter-associated urinary tract infection (CAUTI) rates.
Methods
Retrospective data collection was completed on charts of 120 patients meeting inclusion criteria at Ipswich Hospital in Queensland, Australia, between December 2018 and April 2020. The study variables (including duration of IDC insertion, American Society of Anaesthesiologists (ASA) score, anticholinergic burden score, infection pre- and post-IDC insertion) were compared between successful and unsuccessful TOV groups.
Results
Out of 120 patients, 13 (10.83%) had unsuccessful TOV. IDC duration was not associated with TOV outcome (p-value = 0.82). Higher ASA score (p-value = 0.04), higher anticholinergic burden score (p-value = 0.03) and infection post-IDC insertion (p-value = 0.04) were associated with unsuccessful TOV. 31 (25.83%) patients developed a CAUTI. The mean IDC duration for patients with CAUTI was 6.26 days, compared with patients without CAUTI of 4.34 days (p-value = 0.02).
Conclusions
Duration of IDC insertion was not associated with TOV outcome. Higher ASA score, higher anticholinergic burden score and infection post-IDC insertion were associated with unsuccessful TOV. Increased duration of IDC insertion was associated with increased CAUTI. Future prospective research should be conducted to assist with guideline development.