Deng Si-Si, Zhong Sheng-Sheng, Huang Ling, Wu Wang-Qiu, Luo Jiao, Lu Xin-Huan
Cardiac Surgery Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Cardiothoracic Vascular Surgery, The Guangxi International Zhuang Medicine Hospital, Nanning, Guangxi, China.
Medicine (Baltimore). 2025 Jun 6;104(23):e42691. doi: 10.1097/MD.0000000000042691.
This study investigates the incidence and risk factors associated with the reinsertion of urinary catheters in post-cardiac surgery patients. Conducted at the Cardiac Surgery Ward of a university-affiliated hospital in Nanning, China, from July to December 2021, this cross-sectional study included patients aged 18 years and older undergoing cardiac surgery. Excluded were individuals with genitourinary issues, prostate surgery history, urostomy, cognitive impairment, mental illness, chronic indwelling catheter requirements, hemodialysis, or undergoing interventional surgery. Data on demographic and clinical characteristics were collected to perform multivariable logistic regression to identify risk factors for urinary catheter reinsertion. In our study of 254 cardiac surgery patients, 21 (8.26%) required urinary catheter reinsertion. Notable differences were not seen in age, gender, or body mass index between the reinsertion and no reinsertion groups. However, diabetes was significantly more prevalent in the reinsertion group (19%) compared to the no reinsertion group (3%) (P = .001), with diabetic patients also experiencing longer operative times and older age. The median urinary catheter duration was significantly shorter in the reinsertion group (35.03 hours) versus 60.65 hours for those without reinsertion (P = .034). Early catheter removal within the first postoperative day notably increased reinsertion rates, with 52.4% of early removals requiring reinsertion compared to 23.2% of later removals (P = .003). Multivariable logistic regression highlighted key risk factors: each additional year of age increased reinsertion risk by 3.6% (OR = 1.036, P = .023), and diabetic patients were approximately 8.8 times more likely to require reinsertion (OR = 8.755, P = .004). Early catheter removal was associated with an 8.6-fold increase in reinsertion likelihood (OR = 8.570, P = .001). Our findings emphasize the need for personalized management strategies to prevent urinary catheter reinsertion in cardiac surgery patients, particularly among older individuals, those with diabetes, or whose catheters are removed early post-surgery. These insights are crucial for enhancing postoperative care and minimizing complications associated with urinary catheterization.
本研究调查了心脏手术后患者重新插入导尿管的发生率及相关危险因素。这项横断面研究于2021年7月至12月在中国南宁一家大学附属医院的心外科病房进行，纳入了18岁及以上接受心脏手术的患者。排除患有泌尿生殖系统问题、有前列腺手术史、行尿流改道术、认知障碍、精神疾病、长期留置导尿管需求、血液透析或正在接受介入手术的个体。收集人口统计学和临床特征数据，进行多变量逻辑回归以确定导尿管重新插入的危险因素。在我们对254例心脏手术患者的研究中，21例（8.26%）需要重新插入导尿管。重新插入组与未重新插入组在年龄、性别或体重指数方面未见显著差异。然而，重新插入组糖尿病的患病率（19%）显著高于未重新插入组（3%）（P = 0.001），糖尿病患者手术时间也更长，年龄更大。重新插入组导尿管留置的中位时间（35.03小时）明显短于未重新插入组的60.65小时（P = 0.034）。术后第一天内早期拔除导尿管显著增加重新插入率，早期拔除者中有52.4%需要重新插入，而后期拔除者为23.2%（P = 0.003）。多变量逻辑回归突出了关键危险因素：年龄每增加一岁，重新插入风险增加3.6%（OR = 1.036，P = 0.023），糖尿病患者需要重新插入的可能性约高8.8倍（OR = 8.755，P = 0.004）。早期拔除导尿管与重新插入可能性增加8.6倍相关（OR = 8.570，P = 0.001）。我们的研究结果强调，需要采取个性化管理策略来预防心脏手术患者重新插入导尿管，特别是在老年患者、糖尿病患者或术后早期拔除导尿管的患者中。这些见解对于加强术后护理和减少与导尿相关的并发症至关重要。
