Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Nov 1;8(11):e021708.
doi: 10.1136/bmjopen-2018-021708.

Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study

Leslie Sp Eide  1 , Anette H Ranhoff  2   3 , Sandra Lauck  4   5 , Bengt Fridlund  6 , Rune Haaverstad  2   6 , Karl Ove Hufthammer  7 , Karel K J Kuiper  6 , Jan Erik Nordrehaug  2   8 , Tone Merete Norekvål  1   2   6 ; CARDELIR Investigators
Affiliations
Observational Study

Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study

Leslie Sp Eide et al. BMJ Open. .

Abstract

Objectives: To determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).

Design: Prospective cohort study.

Setting: Tertiary university hospital covering the western region of Norway.

Participants: Octogenarian patients undergoing elective SAVR or TAVI and willing to participate in the study were eligible. Patients unable to speak Norwegian were excluded. Between 2011 and 2013, 143 consecutive patients were included, and data from 136 of them are presented.

Primary outcome: Delirium.

Results: Logistic regression analysis shows that lower cognitive function was positively associated with delirium (OR 0.86, CI 0.74 to 0.99, p=0.047). Besides, the interaction term in the model shows that IUC use and delirium differed between SAVR and TAVI patients (p=0.04). The difference corresponded to a weaker association between hours of IUC use and delirium for SAVR (OR 1.01, CI: 0.99 to 1.03, p=0.54) compared with that for TAVI (OR 1.04, CI: 1.01 to 1.08, p=0.004).

Conclusions: The association between IUC use and delirium is stronger for octogenarian patients treated with TAVI than for patients who received SAVR. Our results revealed a previously unknown association between the number of hours an IUC is used and postoperative delirium in octogenarian patients treated with TAVI.

Keywords: SAVR; TAVI; delirium; octogenarian; urinary catheter.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Estimated ORs (with 95% point-wise CI) for the association between postoperative delirium (response) and surgery type and hours of indwelling urinary catheter use (explanatory variables) for octogenarian patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). The reference level has been set to SAVR and 48 hours (the median number of hours of IUC use in the whole population) (n=136).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Scandroglio AM, Finco G, Pieri M, et al. . Cardiac surgery in 260 octogenarians: a case series. BMC Anesthesiol 2015;15:15:15 10.1186/1471-2253-15-15 - DOI - PMC - PubMed
    1. Smith CR, Leon MB, Mack MJ, et al. . Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011;364:2187–98. 10.1056/NEJMoa1103510 - DOI - PubMed
    1. Barker CM, Reardon MJ. The CoreValve US pivotal trial. Semin Thorac Cardiovasc Surg 2014;26:179–86. 10.1053/j.semtcvs.2014.10.001 - DOI - PubMed
    1. Lauck SB, Kwon JY, Wood DA, et al. . Avoidance of urinary catheterization to minimize in-hospital complications after transcatheter aortic valve implantation: An observational study. Eur J Cardiovasc Nurs 2018;17:66–74. 10.1177/1474515117716590 - DOI - PubMed
    1. Chant C, Smith OM, Marshall JC, et al. . Relationship of catheter-associated urinary tract infection to mortality and length of stay in critically ill patients: a systematic review and meta-analysis of observational studies. Crit Care Med 2011;39:1167–73. 10.1097/CCM.0b013e31820a8581 - DOI - PubMed

Publication types