救急外来を受診した尿閉の患者に対する膀胱減圧後即座の尿道カテーテル抜去と予定外再受診との関連性(Association between immediate removal of urinary catheters from patients with urinary retention after bladder decompression and unplanned return visits to the emergency department)

要旨 【背景】本検討の目的は救急外来を受診した尿閉の患者に対して，膀胱減圧後の即座のカテーテル抜去が受診7日以内の予定外再受診の増加に関連しているか調査することである。【方法】本検討は，2017年4月から2019年3月に相澤病院救急外来を受診し，尿閉に対して尿道カテーテルによる膀胱減圧が行われ，同日に帰宅した患者を対象とした，単施設後方視的コホート研究である。【結果】検討対象は243人となり，そのうちnon–removal group（カテーテルを抜去せずに帰宅した群）が109人，immediate–removal group（カテーテルを抜去して帰宅した群）が134人であった。検討対象を傾向スコアマッチングしたところ，matched non–removal groupが82人，matched immediate–removal groupが82人となった。マッチング後の解析において，主要評価項目である受診7日以内の救急外来への予定外再受診に関して，二群間で差があるとは言えなかった［15（18.3%）vs. 16（19.5%），p>0.99］。【結語】救急外来を受診した尿閉の患者に対して，膀胱減圧後の即座のカテーテル抜去は受診7日以内の予定外再受診の増加に関連しているとは言えなかった。 ABSTRACT Introduction: This study was performed to investigate whether the immediate removal of a urinary catheter from patients with urinary retention after bladder decompression is associated with unplanned return visits to the emergency department. Methods: This is a single center retrospective cohort study. Patients who visited the emergency department of the Aizawa Hospital from April 2017 to March 2019, underwent bladder decompression with urinary catheters for urinary retention and were discharged were enrolled. Results: This study included 243 patients and divided them into non–removal group (deferred removal of urinary catheters, n=109) and immediate–removal group (immediate removal of urinary catheters, n=134). On propensity score matching, matched non–removal group and matched immediate–removal group included 82 patients each. There were no significant differences between the groups on the primary outcome, i.e. the rate of unplanned return visits within seven days after the consultation (15 (18.3%) vs. 16 (19.5%), p>0.99). Conclusion: We found no significant association between immediate removal of urinary catheters from patients with urinary retention after bladder decompression in the emergency department and unplanned return visit within seven days.