Prognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST trial

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dc.contributor.authorOuyang, Menglu
dc.contributor.authorBillot, Laurent
dc.contributor.authorSong, Lili
dc.contributor.authorWang, Xia
dc.contributor.authorRoffe, Christine
dc.contributor.authorArima, Hisatomi
dc.contributor.authorLavados, Pablo
dc.contributor.authorHackett, Maree L
dc.contributor.authorOlavarría, Verónica V
dc.contributor.authorMuñoz Venturelli, Paula
dc.contributor.authorMiddleton, Sandy
dc.contributor.authorPontes-Neto, Octavio M
dc.contributor.authorLee, Tsong-Hai
dc.contributor.authorWatkins, Caroline L
dc.contributor.authorRobinson, Thompson G
dc.contributor.authorAnderson, Craig S
dc.date.accessioned2021-10-26T01:48:50Z
dc.date.available2021-10-26T01:48:50Z
dc.date.issued2021
dc.description.abstractBackground: An indwelling urinary catheter (IUC) is often inserted to manage bladder dysfunction, but its impact on prognosis is uncertain. We aimed to determine the association of IUC use on clinical outcomes after acute stroke in the international, multi-center, cluster crossover, Head Positioning in Acute Stroke Trial (HeadPoST). Methods: Data were analyzed on HeadPoST participants (n = 11,093) randomly allocated to the lying-flat or sitting-up head position. Binomial, logistic regression, hierarchical mixed models were used to determine associations of early insertion of IUC within seven days post-randomization and outcomes of death or disability (defined as "poor outcome," scores 3-6 on the modified Rankin scale) and any urinary tract infection at 90 days with adjustment of baseline and post-randomization management covariates. Results: Overall, 1167 (12%) patients had an IUC, but the frequency and duration of use varied widely across patients in different regions. IUC use was more frequent in older patients, and those with vascular comorbidity, greater initial neurological impairment (on the National Institutes of Health Stroke Scale), and intracerebral hemorrhage as the underlying stroke type. IUC use was independently associated with poor outcome (adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.13-1.74), but not with urinary tract infection after adjustment for antibiotic treatment and stroke severity at hospital separation (aOR: 1.13, 95% CI: 0.59-2.18). The number exposed to IUC for poor outcome was 13. Conclusions: IUC use is associated with a poor outcome after acute stroke. Further studies are required to inform appropriate use of IUC.es
dc.identifier.citationInt J Stroke . 2021 Feb;16(2):200-206es
dc.identifier.urihttps://doi.org/10.1177/1747493020908140es
dc.identifier.urihttp://hdl.handle.net/11447/4919
dc.language.isoenes
dc.subjectUrinary catheteres
dc.subjectAcute strokees
dc.subjectClinical triales
dc.subjectDisabilityes
dc.subjectUrinary tract infectiones
dc.titlePrognostic significance of early urinary catheterization after acute stroke: Secondary analyses of the international HeadPoST triales
dc.typeArticlees

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