Older hospital patients are often catheterized unnecessarily

One-fourth of hospitalized older patients are given medically unnecessary urinary catheters, according to a study conducted at two Ohio hospitals. None of the 378 catheterized patients, who were age 70 years or older, had a medical condition indicating a need for a catheter, reported the study’s authors, from the San Francisco VA Medical Center.

The authors noted that, in previous research, catheterization has been shown to cause urinary infection in one-fourth of patients.

“This highlights the fact that the people who are most likely to suffer the adverse effects of a urinary tract infection are exactly the people who seem to be getting unnecessary catheterizations,” said principal investigator Seth Landefeld, MD.

The study identified nine specific risk factors for unnecessary catheterization: female gender, chronic illness, cognitive impairment, incontinence, inability to carry out common activities of daily living, a physician’s order for bed rest, confusion, falls, and failure to thrive at home. Patients with five or more risk factors had a 50% risk of being catheterized.

“None of these factors are in themselves an indication for having a catheterization,” Dr. Landefeld said. “Other studies have found that most doctors don’t know whether their patient has a catheter in place or not. It’s something that happens frequently for reasons that have not been fully teased out.”

The study was published in the Journal of Patient Safety (2005; 1:201-7).