Urinary retention in diabetic older adults: mortality associated with a urinary catheter inserted during hospitalization but not removed.

Purpose: We have studied, in diabetic older adults with urinary retention (UR), whether a urinary catheter (UC) inserted during hospitalization but not removed is associated with 1-year mortality.

Methods: A retrospective study included 327 consecutive older adults (age ≥ 65 years; median age 83 years; 57.8% males) with UR in whom a UC was inserted during hospitalization: 139 (42.5%) diabetics and 188 (57.5%) nondiabetics. UC removal rates during hospitalization and 1-year mortality rates were studied in both groups. Cox regression analysis was used to assess whether a UC inserted during hospitalization but not removed was independently associated with 1-year mortality.

Results: Most diabetic and non-diabetic patients left the hospital with a UC (66.2% vs. 75.5%; p = 0.082). Overall, 54 (38.8%) diabetic patients and 52 (27.7%) nondiabetic patients died one year later (OR 1.66; 95% CI 1.04-2.65; p = 0.042). Diabetic patients with a UC at discharge day had significantly higher 1-year mortality rates relative to diabetic patients without a UC (48.9% vs. 19.1%; OR 4.04; 95% CI 1.75-9.30; p = 0.001), while in nondiabetic patients there was no significant difference in 1-year mortality rates between patients with or without a UC at discharge day (26.8% vs. 30.4%; p = 0.705). Cox regression analysis showed that only in diabetic patients a UC not removed was independently associated with 1-year mortality (HR 2.56; 95% CI 1.16-5.64; p = 0.019).

Conclusion: A UC inserted but not removed in diabetic older adults with UR is associated with 1-year mortality. Removing a UC and its association with mortality should be studied prospectively in this population.