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Indwelling urethral catheter and mortality in frail elderly women living in community.

Abstract：

AIM:Urinary incontinence is one of the most common, disruptive and often disabling conditions affecting frail older people living in community. The aims of present study were to describe the prevalence of bladder catheter in a population of older women living in community and to examine the relationship between urinary catheter and mortality. METHODS:This was an observational cohort study. We analyzed data from the Italian Silver Network Home Care project that collected data on patients admitted to Home Care programs. A total of twelve Home Health Agencies participated in such project evaluating the implementation of the Minimum Data Set for Home Care (MDS-HC) instrument. A total of 1,004 women were enrolled in the present study. The main outcome measures were prevalence of bladder catheter and 1-year survival according to catheterization. RESULTS:The prevalence of incontinent patients with bladder catheter was 38.1%. Incontinent patients with indwelling bladder catheter did not show significant difference for age and comorbidity while they showed a significant higher level of physical and functional impairment, as expressed by higher score in activities of daily living (ADL) scale (6.5 +/- 1.3 vs. 5.5 +/- 2.2, P < 0.001) and higher prevalence of sensory impairment, pressure ulcers (44% vs. 12%, P < 0.001), and urinary tract infections (21% vs. 10%, P < 0.001). After adjusting for age and for all the variables significantly different between catheterized and not-catheterized subjects at baseline, subjects with indwelling bladder catheter were more likely to die compared to those without catheter (RR, 1.44; 95% CI 1.01-2.07). CONCLUSIONS:Catheterization has an important prognostic implication for frail old women living in the community, independent of age and other clinical and functional variables. A failure in decreasing the unnecessary bladder catheter use and the duration of catheterization among frail incontinent women should be considered an indicator of poor quality of care.

journal_name

Neurourol Urodyn

journal_title

Neurourology and urodynamics

authors

Landi F,Cesari M,Onder G,Zamboni V,Barillaro C,Lattanzio F,Bernabei R

doi

10.1002/nau.20059

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

697-701

issue

eissn

0733-2467

issn

1520-6777

journal_volume

pub_type

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Indwelling urethral catheter and mortality in frail elderly women living in community.