Correlation Analysis Between Indwelling Catheterization And Adverse Outcomes In Patients With Neurogenic Bladder After Stroke

Objective:To analysis between indwelling catheterization and adverse outcomes in patients with neurogenic bladder after stroke;and to explore the related risk factors for urinary tract infections in stroke patients with catheter indwelling;and to put forward guidance of urinary tract management program in clinical practice.Methods: In a total of 204 patients with acute stroke in our hospital were retrospectively analyzed.Using the electronic medical recording system,the medical records of stroke patients admitted from June 2015 to June 2017 were collected by two researchers.The collected informationwas included general information,age,gender,type of stroke(hemorrhage,ischemic,mixed)sexual(male,female),lesion in the brian(left,right,bilateral),type of bladder dysfunction(urinary incontinence,urinary retention,urinary incontinence and urinary retention);indwelling time of urinary catheterization;incidence of urinary tract infection;hospitalization days and hospitalization costs.The possible risk factors associated with urinary tract infection,including age,gender,catheterization time,diabetes,pulmonary infection,bed time,Barthel index,and time of rehabilitation intervention were analysed.Microsoft Excel was used to build a database and SPSS24.0 software package was applied for data analysis.Results:(1)The length of indwelling catheterization: In all the 204 cases of stroke patients,only 23 patients had their catheter removed within 48 hours after admission(accounting for 11.3%),181 patients(accounting for 88.7%)hada retention time longer than 48 hours;male patients with indwelling catheter time slightly longer than women,no significant difference were found(P> 0.05);length of indwelling catheterization in patients with urinary retention,urinary incontinence,and the mixed symptoms was 11.0 ± 2.1 days,13.3 ± 2.5,and 9.66 ± 2.8 days respectively,and no significant differences were found among groups(P> 0.05).(2)Correlation of adverse effects after indwelling catheterization: The longer the retention time,the more frequent urinary tract infections occurred(r=0.457,P ? 0.05),and the length of hospital stay was extended(r = 0.563 P ? 0.05),as well as the hospital costs(r = 0.440,P ? 0.05),all statistically significant.No correlationbetween the catheter retentiontime and the Bathel Index when admmitted,and this is not statistical significant(r=0.025,P>0.05)?(3)Analysis of risk factors for urinary tract infection: Within all the 204 patients that were analysised the incidence of urinary tract infection was as high as 57.8%.Gender,stroke type,and location of the lesion were not found to be the risk factors for urinary tract infection by Chi-square test(P> 0.05).However,longer indwelling catheter retention(>7 days),diabetes,lung infection,prolonged bed time(>7 days),zero Barthel index when addmitted,and delayed rehabilitationinitiating time(>7 days)were risk factors for urinary tract infection,the difference was statistically significant(P?0.05).Logistic regression analysis showed that indwelling catheter for a long time(> 7 days),diabetes,lung infection,and delayed rehabilitationinitiatingtime(late than 7 days)were independent risk factors for urinary tract infection.Conclusion:(1)Long period of indwelling catheter was commonly found in stroke patients,which may lead to adverse consequences such as urinary tract infections,increased hospitalization costs,and prolonged hospital stays.(2)With the prolongation of the indwelling catheter in patients with stroke,the infection rate of urinary tract infections also increases.(3)Indwelling catheter for a long time(> 7 days),diabetes,lung infection,and delayed rehabilitationinitiating time(late than 7 days)were risk factors for urinary tract infection in stroke patients with stroke.