Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement
The minimalist approach to transcatheter aortic valve replacement (TAVR) focuses on avoiding extraneous invasive measures. Data describing the clinical impact of routine indwelling urinary catheter (IUC) in TAVR patients is limited. We sought to examine outcomes after IUC placement in patients under...
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| Veröffentlicht in: | The Journal of invasive cardiology 2020-07, Vol.32 (7), p.269 |
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| creator | Lampert, Joshua Finn, Matthew T Kantor, Alex Akkoc, Deniz Chen, Shmuel Brandwein, Russel Fidlow, Kathryn Liao, Ming Khalique, Omar Hahn, Rebecca T Vahl, Torsten P George, Isaac Kirtane, Ajay Leon, Martin B Kodali, Susheel K Nazif, Tamim M |
| description | The minimalist approach to transcatheter aortic valve replacement (TAVR) focuses on avoiding extraneous invasive measures. Data describing the clinical impact of routine indwelling urinary catheter (IUC) in TAVR patients is limited. We sought to examine outcomes after IUC placement in patients undergoing TAVR.
We performed a retrospective analysis of 773 consecutive patients undergoing TAVR between 2011 and 2015. Patients were excluded who did not receive an IUC, had a pre-existing IUC, had renal replacement therapy, or underwent non-transfemoral TAVR. Patients were classified by presence of the composite of in-hospital urologic adverse events (UAEs), defined as urinary retention, IUC reinsertion, discharge with IUC, new hematuria, or urinary tract infection (UTI). The primary study endpoint was all-cause mortality at 1 year.
A total of 520 patients met study criteria and were analyzed. The incidence of UAE was 28.6%. Urinary retention after IUC removal occurred in 14.6% of patients. UTIs occurred in 6.5% and acute kidney injury occurred in 13.6% of IUC patients. UAE was associated with an increased rate of 30-day and 1-year all-cause mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.09-7.35; P=.02 and HR, 1.96; 95% CI, 1.22-3.16; P |
| doi_str_mv | 10.25270/jic/19.00458 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2419714744</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2419714744</sourcerecordid><originalsourceid>FETCH-LOGICAL-c249t-a3a088c305343b684e1ed204af85c34aa1f623bb41ee9c1fb316b17d4bf8203e3</originalsourceid><addsrcrecordid>eNpNkElPwzAQRi0EoqVw5Ipy5JLWYzvbsSpbpUog1HKNHGdSXGXDTlrx73EXEKf5NPP0pPkIuQU6ZgGL6GSj1QSSMaUiiM_IEIIg8llA4fxfHpArazeUMuAJXJIBZyFQFsZDsluZpmzWWnmzpmpLrWSnm9p6uvbeXMS6s947KtRbXa-9eZ3vsCz3cWV0Lc23N5PdJ3ZorPfQm_1haWRt1WnrTRvTOfmHLLfoRG0pFVbOek0uCllavDnNEVk9PS5nL_7i9Xk-my58xUTS-ZJLGseK04ALnoWxQMCcUSGLOFBcSAlFyHiWCUBMFBQZhzCDKBdZETPKkY_I_dHbmuarR9ullbbK_SBrbHqbMgFJBCISwqH-EVWmsdZgkbZGV-7HFGh66Dp1XaeQpIeuHX93UvdZhfkf_Vsu_wFJrHxZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2419714744</pqid></control><display><type>article</type><title>Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Lampert, Joshua ; Finn, Matthew T ; Kantor, Alex ; Akkoc, Deniz ; Chen, Shmuel ; Brandwein, Russel ; Fidlow, Kathryn ; Liao, Ming ; Khalique, Omar ; Hahn, Rebecca T ; Vahl, Torsten P ; George, Isaac ; Kirtane, Ajay ; Leon, Martin B ; Kodali, Susheel K ; Nazif, Tamim M</creator><creatorcontrib>Lampert, Joshua ; Finn, Matthew T ; Kantor, Alex ; Akkoc, Deniz ; Chen, Shmuel ; Brandwein, Russel ; Fidlow, Kathryn ; Liao, Ming ; Khalique, Omar ; Hahn, Rebecca T ; Vahl, Torsten P ; George, Isaac ; Kirtane, Ajay ; Leon, Martin B ; Kodali, Susheel K ; Nazif, Tamim M</creatorcontrib><description>The minimalist approach to transcatheter aortic valve replacement (TAVR) focuses on avoiding extraneous invasive measures. Data describing the clinical impact of routine indwelling urinary catheter (IUC) in TAVR patients is limited. We sought to examine outcomes after IUC placement in patients undergoing TAVR.
We performed a retrospective analysis of 773 consecutive patients undergoing TAVR between 2011 and 2015. Patients were excluded who did not receive an IUC, had a pre-existing IUC, had renal replacement therapy, or underwent non-transfemoral TAVR. Patients were classified by presence of the composite of in-hospital urologic adverse events (UAEs), defined as urinary retention, IUC reinsertion, discharge with IUC, new hematuria, or urinary tract infection (UTI). The primary study endpoint was all-cause mortality at 1 year.
A total of 520 patients met study criteria and were analyzed. The incidence of UAE was 28.6%. Urinary retention after IUC removal occurred in 14.6% of patients. UTIs occurred in 6.5% and acute kidney injury occurred in 13.6% of IUC patients. UAE was associated with an increased rate of 30-day and 1-year all-cause mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.09-7.35; P=.02 and HR, 1.96; 95% CI, 1.22-3.16; P<.01, respectively). After multivariable adjustment for important baseline differences, UAEs were associated with significantly greater hazard of 1-year mortality (adjusted HR, 1.79; 95% CI, 1.07-2.99; P=.03) but not 30-day mortality (adjusted HR, 1.96; 95% CI, 0.67-5.49; P=.22).
UAEs were frequent in patients receiving an IUC during TAVR and were associated with substantial morbidity, as well as longer hospital stay. Further research is required to establish whether avoidance of IUC as a component of the minimalist approach will reduce UAEs.</description><identifier>ISSN: 1557-2501</identifier><identifier>EISSN: 1557-2501</identifier><identifier>DOI: 10.25270/jic/19.00458</identifier><identifier>PMID: 32610268</identifier><language>eng</language><publisher>United States</publisher><subject>Aortic Valve - surgery ; Aortic Valve Stenosis - diagnosis ; Aortic Valve Stenosis - surgery ; Catheters, Indwelling - adverse effects ; Humans ; Retrospective Studies ; Risk Factors ; Time Factors ; Transcatheter Aortic Valve Replacement - adverse effects ; Treatment Outcome ; Urinary Catheterization - adverse effects ; Urinary Catheters</subject><ispartof>The Journal of invasive cardiology, 2020-07, Vol.32 (7), p.269</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-0890-156X ; 0000-0003-1850-8665 ; 0000-0001-8843-1777</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32610268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lampert, Joshua</creatorcontrib><creatorcontrib>Finn, Matthew T</creatorcontrib><creatorcontrib>Kantor, Alex</creatorcontrib><creatorcontrib>Akkoc, Deniz</creatorcontrib><creatorcontrib>Chen, Shmuel</creatorcontrib><creatorcontrib>Brandwein, Russel</creatorcontrib><creatorcontrib>Fidlow, Kathryn</creatorcontrib><creatorcontrib>Liao, Ming</creatorcontrib><creatorcontrib>Khalique, Omar</creatorcontrib><creatorcontrib>Hahn, Rebecca T</creatorcontrib><creatorcontrib>Vahl, Torsten P</creatorcontrib><creatorcontrib>George, Isaac</creatorcontrib><creatorcontrib>Kirtane, Ajay</creatorcontrib><creatorcontrib>Leon, Martin B</creatorcontrib><creatorcontrib>Kodali, Susheel K</creatorcontrib><creatorcontrib>Nazif, Tamim M</creatorcontrib><title>Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement</title><title>The Journal of invasive cardiology</title><addtitle>J Invasive Cardiol</addtitle><description>The minimalist approach to transcatheter aortic valve replacement (TAVR) focuses on avoiding extraneous invasive measures. Data describing the clinical impact of routine indwelling urinary catheter (IUC) in TAVR patients is limited. We sought to examine outcomes after IUC placement in patients undergoing TAVR.
We performed a retrospective analysis of 773 consecutive patients undergoing TAVR between 2011 and 2015. Patients were excluded who did not receive an IUC, had a pre-existing IUC, had renal replacement therapy, or underwent non-transfemoral TAVR. Patients were classified by presence of the composite of in-hospital urologic adverse events (UAEs), defined as urinary retention, IUC reinsertion, discharge with IUC, new hematuria, or urinary tract infection (UTI). The primary study endpoint was all-cause mortality at 1 year.
A total of 520 patients met study criteria and were analyzed. The incidence of UAE was 28.6%. Urinary retention after IUC removal occurred in 14.6% of patients. UTIs occurred in 6.5% and acute kidney injury occurred in 13.6% of IUC patients. UAE was associated with an increased rate of 30-day and 1-year all-cause mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.09-7.35; P=.02 and HR, 1.96; 95% CI, 1.22-3.16; P<.01, respectively). After multivariable adjustment for important baseline differences, UAEs were associated with significantly greater hazard of 1-year mortality (adjusted HR, 1.79; 95% CI, 1.07-2.99; P=.03) but not 30-day mortality (adjusted HR, 1.96; 95% CI, 0.67-5.49; P=.22).
UAEs were frequent in patients receiving an IUC during TAVR and were associated with substantial morbidity, as well as longer hospital stay. Further research is required to establish whether avoidance of IUC as a component of the minimalist approach will reduce UAEs.</description><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - diagnosis</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Treatment Outcome</subject><subject>Urinary Catheterization - adverse effects</subject><subject>Urinary Catheters</subject><issn>1557-2501</issn><issn>1557-2501</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkElPwzAQRi0EoqVw5Ipy5JLWYzvbsSpbpUog1HKNHGdSXGXDTlrx73EXEKf5NPP0pPkIuQU6ZgGL6GSj1QSSMaUiiM_IEIIg8llA4fxfHpArazeUMuAJXJIBZyFQFsZDsluZpmzWWnmzpmpLrWSnm9p6uvbeXMS6s947KtRbXa-9eZ3vsCz3cWV0Lc23N5PdJ3ZorPfQm_1haWRt1WnrTRvTOfmHLLfoRG0pFVbOek0uCllavDnNEVk9PS5nL_7i9Xk-my58xUTS-ZJLGseK04ALnoWxQMCcUSGLOFBcSAlFyHiWCUBMFBQZhzCDKBdZETPKkY_I_dHbmuarR9ullbbK_SBrbHqbMgFJBCISwqH-EVWmsdZgkbZGV-7HFGh66Dp1XaeQpIeuHX93UvdZhfkf_Vsu_wFJrHxZ</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Lampert, Joshua</creator><creator>Finn, Matthew T</creator><creator>Kantor, Alex</creator><creator>Akkoc, Deniz</creator><creator>Chen, Shmuel</creator><creator>Brandwein, Russel</creator><creator>Fidlow, Kathryn</creator><creator>Liao, Ming</creator><creator>Khalique, Omar</creator><creator>Hahn, Rebecca T</creator><creator>Vahl, Torsten P</creator><creator>George, Isaac</creator><creator>Kirtane, Ajay</creator><creator>Leon, Martin B</creator><creator>Kodali, Susheel K</creator><creator>Nazif, Tamim M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0890-156X</orcidid><orcidid>https://orcid.org/0000-0003-1850-8665</orcidid><orcidid>https://orcid.org/0000-0001-8843-1777</orcidid></search><sort><creationdate>202007</creationdate><title>Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement</title><author>Lampert, Joshua ; Finn, Matthew T ; Kantor, Alex ; Akkoc, Deniz ; Chen, Shmuel ; Brandwein, Russel ; Fidlow, Kathryn ; Liao, Ming ; Khalique, Omar ; Hahn, Rebecca T ; Vahl, Torsten P ; George, Isaac ; Kirtane, Ajay ; Leon, Martin B ; Kodali, Susheel K ; Nazif, Tamim M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c249t-a3a088c305343b684e1ed204af85c34aa1f623bb41ee9c1fb316b17d4bf8203e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - diagnosis</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Treatment Outcome</topic><topic>Urinary Catheterization - adverse effects</topic><topic>Urinary Catheters</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lampert, Joshua</creatorcontrib><creatorcontrib>Finn, Matthew T</creatorcontrib><creatorcontrib>Kantor, Alex</creatorcontrib><creatorcontrib>Akkoc, Deniz</creatorcontrib><creatorcontrib>Chen, Shmuel</creatorcontrib><creatorcontrib>Brandwein, Russel</creatorcontrib><creatorcontrib>Fidlow, Kathryn</creatorcontrib><creatorcontrib>Liao, Ming</creatorcontrib><creatorcontrib>Khalique, Omar</creatorcontrib><creatorcontrib>Hahn, Rebecca T</creatorcontrib><creatorcontrib>Vahl, Torsten P</creatorcontrib><creatorcontrib>George, Isaac</creatorcontrib><creatorcontrib>Kirtane, Ajay</creatorcontrib><creatorcontrib>Leon, Martin B</creatorcontrib><creatorcontrib>Kodali, Susheel K</creatorcontrib><creatorcontrib>Nazif, Tamim M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of invasive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lampert, Joshua</au><au>Finn, Matthew T</au><au>Kantor, Alex</au><au>Akkoc, Deniz</au><au>Chen, Shmuel</au><au>Brandwein, Russel</au><au>Fidlow, Kathryn</au><au>Liao, Ming</au><au>Khalique, Omar</au><au>Hahn, Rebecca T</au><au>Vahl, Torsten P</au><au>George, Isaac</au><au>Kirtane, Ajay</au><au>Leon, Martin B</au><au>Kodali, Susheel K</au><au>Nazif, Tamim M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement</atitle><jtitle>The Journal of invasive cardiology</jtitle><addtitle>J Invasive Cardiol</addtitle><date>2020-07</date><risdate>2020</risdate><volume>32</volume><issue>7</issue><spage>269</spage><pages>269-</pages><issn>1557-2501</issn><eissn>1557-2501</eissn><abstract>The minimalist approach to transcatheter aortic valve replacement (TAVR) focuses on avoiding extraneous invasive measures. Data describing the clinical impact of routine indwelling urinary catheter (IUC) in TAVR patients is limited. We sought to examine outcomes after IUC placement in patients undergoing TAVR.
We performed a retrospective analysis of 773 consecutive patients undergoing TAVR between 2011 and 2015. Patients were excluded who did not receive an IUC, had a pre-existing IUC, had renal replacement therapy, or underwent non-transfemoral TAVR. Patients were classified by presence of the composite of in-hospital urologic adverse events (UAEs), defined as urinary retention, IUC reinsertion, discharge with IUC, new hematuria, or urinary tract infection (UTI). The primary study endpoint was all-cause mortality at 1 year.
A total of 520 patients met study criteria and were analyzed. The incidence of UAE was 28.6%. Urinary retention after IUC removal occurred in 14.6% of patients. UTIs occurred in 6.5% and acute kidney injury occurred in 13.6% of IUC patients. UAE was associated with an increased rate of 30-day and 1-year all-cause mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.09-7.35; P=.02 and HR, 1.96; 95% CI, 1.22-3.16; P<.01, respectively). After multivariable adjustment for important baseline differences, UAEs were associated with significantly greater hazard of 1-year mortality (adjusted HR, 1.79; 95% CI, 1.07-2.99; P=.03) but not 30-day mortality (adjusted HR, 1.96; 95% CI, 0.67-5.49; P=.22).
UAEs were frequent in patients receiving an IUC during TAVR and were associated with substantial morbidity, as well as longer hospital stay. Further research is required to establish whether avoidance of IUC as a component of the minimalist approach will reduce UAEs.</abstract><cop>United States</cop><pmid>32610268</pmid><doi>10.25270/jic/19.00458</doi><orcidid>https://orcid.org/0000-0003-0890-156X</orcidid><orcidid>https://orcid.org/0000-0003-1850-8665</orcidid><orcidid>https://orcid.org/0000-0001-8843-1777</orcidid></addata></record> |
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| subjects | Aortic Valve - surgery Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - surgery Catheters, Indwelling - adverse effects Humans Retrospective Studies Risk Factors Time Factors Transcatheter Aortic Valve Replacement - adverse effects Treatment Outcome Urinary Catheterization - adverse effects Urinary Catheters |
| title | Urologic Complications in Patients Receiving Indwelling Urinary Catheters During Transcatheter Aortic Valve Replacement |
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