American journal of surgery · 2020
Impact of Enhanced Recovery Pathways and early urinary catheter removal on post-operative urinary retention.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Tam Vernissia, Lutfi Waseem, Morgan Katrina, Vasan Robin, Scaife Robin, Mahler Brandon, Medich David S, Celebrezze James P, Watson Andrew R, Holder-Murray Jennifer
Аннотация
BACKGROUND: Post-operative urinary retention (POUR) is a common complication after colorectal surgery. Enhanced recovery pathways (ERP) typically include early catheter removal but may place patients at risk for POUR.
METHODS: This is a retrospective cohort analysis of patients undergoing colorectal surgery at a single institution between April 2014 and November 2017. Patients were stratified into non-ERP and ERP cohorts and post-operative outcomes were compared.
RESULTS: Of 284 patients studied, ERP was applied to 161 (57%) while the remaining 123 (43%) recovered under standard care. Median duration of indwelling Foleys was 1 day for ERP and 2 days for non-ERP patients (p < 0.001). ERP patients experienced higher rates of straight catheterization (22% vs 12%,p = 0.036), Foley reinsertion (14% vs 7%,p = 0.07), and initiation of alpha antagonists (12% vs 5%,p = 0.04). Significant independent predictors of POUR were age (OR 1.03, p = 0.002), male gender (OR 2.79, p = 0.001), surgery duration (OR 1.27, p = 0.027), and ERP (OR 1.96, p = 0.025).
CONCLUSION: ERP following colorectal surgery that include routine early Foley catheter removal on post-operative day one is associated with increased rates of POUR; however, this did not lead to increased rates of catheter-associated urinary tract infections during the index admission in the population studied.
METHODS: This is a retrospective cohort analysis of patients undergoing colorectal surgery at a single institution between April 2014 and November 2017. Patients were stratified into non-ERP and ERP cohorts and post-operative outcomes were compared.
RESULTS: Of 284 patients studied, ERP was applied to 161 (57%) while the remaining 123 (43%) recovered under standard care. Median duration of indwelling Foleys was 1 day for ERP and 2 days for non-ERP patients (p < 0.001). ERP patients experienced higher rates of straight catheterization (22% vs 12%,p = 0.036), Foley reinsertion (14% vs 7%,p = 0.07), and initiation of alpha antagonists (12% vs 5%,p = 0.04). Significant independent predictors of POUR were age (OR 1.03, p = 0.002), male gender (OR 2.79, p = 0.001), surgery duration (OR 1.27, p = 0.027), and ERP (OR 1.96, p = 0.025).
CONCLUSION: ERP following colorectal surgery that include routine early Foley catheter removal on post-operative day one is associated with increased rates of POUR; however, this did not lead to increased rates of catheter-associated urinary tract infections during the index admission in the population studied.