Assessment of Risk Factors for Reinsertion of Indwelling Urinary Catheters Despite Intervention for Voiding Disturbances by the Urination Care Team

Abstract

A urination care team comprising professionals from various fields was developed. This team intervened during hospitalization of patients who were either expected to have voiding disturbances following the removal of indwelling urinary catheters or develop voiding disturbances following catheter removal during hospitalization. The team aims to remove unnecessary indwelling urinary catheters and promote patient independence during urination. However, if patients do not achieve spontaneous micturition or clean intermittent self-catheterization (CISC) during their hospital stay, an indwelling urinary catheter is reinserted. In this study, risk factors for indwelling urinary catheter reinsertion were retrospectively analyzed during hospitalization. In total, 98 patients from January 1, 2018, to December 31, 2020, were examined at Kyoto Katsura Hospital, where the urination care team intervened due to voiding disturbances with residual urine of ≥100 ml. At discharge, 46 (46%) patients were able to urinate independently, 9 (9%) were voiding through a diaper, 14 (14%) practiced CISC, and 29 (30%) had indwelling urinary catheters. Multivariate analysis revealed that age ≥75 years (p＝0.03), a cognitive functional independence measure (FIM) score of ≤25 on admission (p＜0.01), and residual urine of ≥300 ml at intervention (p＝0.03) were independent risk factors affecting the indwelling urinary catheter reinsertion. The indwelling urinary catheter non-reinsertion and reinsertion groups demonstrated significant improvement in the FIM total and motor scores between admission and discharge ; however, the FIM cognitive score did not show any statistically significant difference.