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

To study in diabetic older adults with urinary retention whether a urinary catheter inserted during hospitalization but not removed is associated with increased 1-year mortality rates. Diabetic older adults with a urinary catheter inserted during hospitalization but not removed have significantly higher 1-year mortality rates relative to diabetic older adults in whom the catheter was removed, while in nondiabetic patients there is no difference in 1-year mortality rates between patients with or without a urinary catheter. Removing a urinary catheter inserted during hospitalization and its association with mortality should be studied prospectively in diabetic older adults with urinary retention. 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. 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. 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). 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.