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
. 2023 May;47(5):1345-1352.
doi: 10.1007/s00264-023-05755-4. Epub 2023 Mar 8.

Insertion of a urinary catheter on admission lowers acute kidney injury incidence in patients with hip fractures

Alaa Abu-Saleh  1 , Lior Feintuch  2 , Adi Shani  1 , Ruth Rahamimov  3 , Nimrod Rahamimov  4   5
Affiliations

Insertion of a urinary catheter on admission lowers acute kidney injury incidence in patients with hip fractures

Alaa Abu-Saleh et al. Int Orthop. 2023 May.

Abstract

Purpose: Acute kidney injury (AKI) is a common adverse event in patients undergoing hip fracture repair surgery, increasing morbidity and mortality. Our study hypothesis was that routine insertion of a urinary catheter, on admission to the hospital or immediately before surgery, will reduce AKI incidence in hip fracture patients.

Methods: Determined by alternating days of admission, a urinary catheter was inserted routinely on admission (catheter group) or as needed (non-catheter group) in 250 consecutive patients who presented with a hip fracture to our emergency department. The incidence of AKI according to the KDIGO criteria and morbidity and mortality were compared between the study groups.

Results: The overall incidence of AKI was 11.6% (29/250). The catheter group (N = 122) had a significantly lower rate of AKI (6.6% vs. 16% p = 0.018). At 12-month follow-up, the overall mortality was 10.8% (27/250), in-hospital 7.4% (2/27), short-term (within 30 days) 7.4% (2/27), and long-term (30 days to 1 year) 85.8% (23/27). All in-hospital mortality occurred in the AKI group. Patients with no AKI had a better survival rate; however, the difference was not significant (p-value = 0.21). Mortality rate was lower in the catheter group but not significant (8.2% compared with 13.8% in the non-catheter group, p = 0.225). Post-operative respiratory and cardiac complications were more frequent in the AKI group (p = 0.02 and 0.043 accordingly).

Conclusions: Insertion of a urinary catheter upon admission or before surgery lowered AKI incidence significantly. Peri-operative AKI was associated with higher rates of post-operative complications and worse survival.

Keywords: Acute kidney injury; Geriatric trauma; Hip fracture; Urinary catheter.

PubMed Disclaimer

References

    1. Bagshaw SM, George C, Gibney RT, Bellomo R (2008) A multi-center evaluation of early acute kidney injury in critically ill trauma patients. Ren Fail 30:581–589. https://doi.org/10.1080/08860220802134649 - DOI - PubMed
    1. Bell S, Dekker FW, Vadiveloo T, Marwick C, Deshmukh H, Donnan PT, Van Diepen M (2015) Risk of postoperative acute kidney injury in patients undergoing orthopaedic surgery–development and validation of a risk score and effect of acute kidney injury on survival: observational cohort study. Bmj 351:h5639. https://doi.org/10.1136/bmj.h5639 - DOI - PubMed - PMC
    1. Bell S, Ross VC, Zealley KA, Millar F, Isles C (2017) Management of post-operative acute kidney injury. Qjm 110:695–700. https://doi.org/10.1093/qjmed/hcw175 - DOI - PubMed
    1. Bennet SJ, Berry OM, Goddard J, Keating JF (2010) Acute renal dysfunction following hip fracture. Injury 41:335–338. https://doi.org/10.1016/j.injury.2009.07.009 - DOI - PubMed
    1. Clarke K, Hall CL, Wiley Z, Tejedor SC, Kim JS, Reif L, Witt L, Jacob JT (2020) Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention. J Hosp Med 15:552–556. https://doi.org/10.12788/jhm.3292 - DOI - PubMed

LinkOut - more resources