Summary

Urinary catheterization of patients with acute heart failure in a hospital emergency department: a factor associated with prognosis

Alberto Domínguez-Rodríguez1-3, Néstor Báez-Ferrer1, Guillermo Burillo-Putze2,4, Virginia Domínguez-González5, Pedro Abreu-González6, Daniel Hernández-Vaquero7,8

Affiliation of the authors

1Servicio de Cardiología, Hospital Universitario de Canarias, Tenerife, Spain. 2Universidad Europea de Canarias, Tenerife, Spain. 3CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 4Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain. 5Facultad de Medicina, Universidad de La Laguna, Tenerife, Spain. 6Departamento de Fisiología, Facultad de Medicina, Universidad de La Laguna, Tenerife, Spain. 7Área del Corazón, Hospital Universitario Central de Asturias, Oviedo. Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain. 8Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Spain.

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Domínguez-Rodríguez A, Báez-Ferrer N, Burillo-Putze G, Domínguez-González V, Abreu-González P, Hernández-Vaquero D. Urinary catheterization of patients with acute heart failure in a hospital emergency department: a factor associated with prognosis. Emergencias. 2023;35:409-14

Summary

Objective.

To analyze whether urinary catheterization in a hospital emergency department (ED) affects short-term prognosis in patients with acute heart failure (AHF).

Methods.

We prospectively recorded baseline and other clinical data in a consecutive cohort of ED patients treated for AHF. Crude and adjusted associations were calculated between catheterization and a primary composite outcome (30-day readmission for AHF and/or death) and secondary outcomes (in-hospital mortality, urinary tract infection [UTI], and duration of hospital stay.)

Results.

Nine hundred ninety-one patients were admitted for AHF. The mean (SD) age was 66 (10.5) years; 71% were women. Catheterization was required for 29.2% in the ED. The primary composite outcome was observed in 7.7% of the patients who were not catheterized and 12.8% of the catheterized patients (P = .02). In-hospital mortality occurred in 5.9% and 9.7% of non-catheterized and catheterized patients, respectively (P = .04), and UTIs occurred in 19.1% and 26.6% (P = .01). Twelve of the non-catheterized patients (1.7%) were readmitted for AHF (vs 11 (3.8%) of the catheterized patients (P = .06), and there were no differences between the groups in hospital stay (11 vs 10.9 days, P = .78). In the adjusted analysis of associations between catheterization and the primary outcome the odds and hazard ratios (OR and HR, respectively) were OR, 1.7 (95% CI, 1.1-2.7) (P = .02) and HR, 1.6 (95% CI, 1.1-2.5) (P = .03). For secondary outcomes, significant associations emerged between catheterization and UTIs (OR, 1.8 [95% CI, 1.1–2.2]; P = .008) and readmission for AHF (OR, 2.9 [95% CI, 1.2-7.3]; P = .02).
Conclusion. Routine insertion of a urinary catheter in patients with AHF in the ED is associated with worse 30-day clinical outcomes.

 

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