PD38-06 A NOVEL RISK PREDICTION MODEL TO TRIAGE DIFFICULT URETHRAL CATHETERIZATIONS

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety III (PD38)1 Sep 2021PD38-06 A NOVEL RISK PREDICTION MODEL TO TRIAGE DIFFICULT URETHRAL CATHETERIZATIONS Albert Ha, Jamie Pak, Christopher Haas, Caleb Miles, David Weiner, Christopher Anderson, and Gina Badalato Albert HaAlbert Ha More articles by this author , Jamie PakJamie Pak More articles by this author , Christopher HaasChristopher Haas More articles by this author , Caleb MilesCaleb Miles More articles by this author , David WeinerDavid Weiner More articles by this author , Christopher AndersonChristopher Anderson More articles by this author , and Gina BadalatoGina Badalato More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002048.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While urologic consultations for Foley catheter placement are important, improper placement can lead to potentially preventable complications. We constructed a risk prediction model to identify cases of difficult urethral catheterizations (DUC). METHODS: Using a single-institution database of urologic consults for Foley catheterizations from June 2016 to January 2020, a model to predict DUC in male patients was constructed. DUC was defined as requiring the use of a guidewire, cystoscopy, urethral dilation, and/or new suprapubic tube (SPT) placement, while a simple Foley was defined as an uncomplicated placement of a regular or coude catheter. Repeat encounters and routine SPT exchanges were excluded. A multivariable model was constructed using logistic regression, and its performance was internally validated using bootstrap statistics. RESULTS: A total of 841 consults were identified, with 181 (27%) classified as a DUC. Numerous factors were associated with difficult placement, with patients with a prior history of urethral stricture (adjusted OR: 6.8, 95% CI: 3.34-14.18, p <0.001) having the greatest magnitude of effect (Table 1). Bootstrap analysis of the final model demonstrated good overall accuracy (predictive accuracy: 76%) (Figure 1A). A predictive nomogram was also constructed using the multivariable model (Figure 1B). CONCLUSIONS: This model is a promising tool to triage a DUC, which can be used to identify patients who likely require placement by a urologist to potentially reduce catheterization-related complications. The high rate of uncomplicated catheterizations also highlights the need for further education on proper technique. External validation and application to the initial Foley encounter will shed additional light on its overall utility. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e664-e664 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Albert Ha More articles by this author Jamie Pak More articles by this author Christopher Haas More articles by this author Caleb Miles More articles by this author David Weiner More articles by this author Christopher Anderson More articles by this author Gina Badalato More articles by this author Expand All Advertisement Loading ...