Incidence and predictive factors of urinary catheter reinsertion in cardiac surgery patients: A cross-sectional study in Nanning, China

This study investigates the incidence and risk factors associated with the reinsertion of urinary catheters in post-cardiac surgery patients. Conducted at the Cardiac Surgery Ward of a university-affiliated hospital in Nanning, China, from July to December 2021, this cross-sectional study included patients aged 18 years and older undergoing cardiac surgery. Excluded were individuals with genitourinary issues, prostate surgery history, urostomy, cognitive impairment, mental illness, chronic indwelling catheter requirements, hemodialysis, or undergoing interventional surgery. Data on demographic and clinical characteristics were collected to perform multivariable logistic regression to identify risk factors for urinary catheter reinsertion. In our study of 254 cardiac surgery patients, 21 (8.26%) required urinary catheter reinsertion. Notable differences were not seen in age, gender, or body mass index between the reinsertion and no reinsertion groups. However, diabetes was significantly more prevalent in the reinsertion group (19%) compared to the no reinsertion group (3%) (P = .001), with diabetic patients also experiencing longer operative times and older age. The median urinary catheter duration was significantly shorter in the reinsertion group (35.03 hours) versus 60.65 hours for those without reinsertion (P = .034). Early catheter removal within the first postoperative day notably increased reinsertion rates, with 52.4% of early removals requiring reinsertion compared to 23.2% of later removals (P = .003). Multivariable logistic regression highlighted key risk factors: each additional year of age increased reinsertion risk by 3.6% (OR = 1.036, P = .023), and diabetic patients were approximately 8.8 times more likely to require reinsertion (OR = 8.755, P = .004). Early catheter removal was associated with an 8.6-fold increase in reinsertion likelihood (OR = 8.570, P = .001). Our findings emphasize the need for personalized management strategies to prevent urinary catheter reinsertion in cardiac surgery patients, particularly among older individuals, those with diabetes, or whose catheters are removed early post-surgery. These insights are crucial for enhancing postoperative care and minimizing complications associated with urinary catheterization.