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Urinary catheterization prior to PCI worsens clinical outcomes in patients with acute myocardial infarction

Published:December 30, 2022DOI:https://doi.org/10.1016/j.jjcc.2022.12.007

      Highlights

      • Many patients with acute myocardial infarction had indwelling urinary catheters.
      • Indwelling urethral catheter was associated with in-hospital adverse urinary events.
      • Shorter duration of indwelling urethral catheter use decreased urinal complications.
      • Routine use of indwelling urethral catheter might not be recommended.

      Abstract

      Background

      Indwelling urethral catheters (IUCs) are used to measure urine volume, keep patients on bed rest, or keep the groin area clean in patients with acute myocardial infarction (AMI). However, the association between IUC use and in-hospital urinary-related complications is unknown.

      Methods

      This was a single-center retrospective analysis of 303 patients admitted to our hospital in 2018–2020 who had AMI without cardiogenic shock. An IUC was inserted in the emergency room upon initiation of invasive catheter treatment and removed as soon as possible. The primary outcome was in-hospital adverse urinary event (IHAUE), which consisted of in-hospital urinary tract infection and in-hospital gross hematuria.

      Results

      Of 303 patients, 243 patients (80.2 %) underwent IUC insertion. A lower proportion of patients with IUCs were male (72 % vs. 85 %, p = 0.044). A higher proportion had Killip classification 2 or 3 (13 % vs. 0 %, p = 0.003) or ST-elevation myocardial infarction (65 % vs. 32 %, p < 0.001). IHAUEs occurred significantly more commonly in patients with IUCs than without IUCs (11 % vs. 2 %, p = 0.023). Kaplan-Meier analysis showed that IHAUEs occurred more frequently in patients with IUCs than patients without IUCs (log-rank test p = 0.033). Furthermore, IUC use longer than the median of 2 days was associated with a higher odds ratio (OR) for IHAUE when compared with those without IUC use (OR, 3.65; 95 % confidence interval, 1.28–10.4; p = 0.015). There were no significant differences in in-hospital mortality by IUC status.

      Conclusions

      IUC use is associated with a higher risk of IHAUEs in patients with uncomplicated AMI. Routine IUC use might not be recommended.

      Graphical abstract

      Keywords

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