The Study On Risk Factors For Catheter Encrustation In Long-term Catheterized Patients

Objective:Biofilm infections is inevitable in long-term catheterized patients,most of which are rarely completely free of catheter encrustation,and conversely it can aggravate infection.There are many other complications associated with catheter encrustation such as blockage,leakage,difficult removing,bladder stones and so on.The purpose of this article is to investigate relative factors for encrustation and construct model to supply evidence of antiencrustation and choosing suitable catheter management strategies and administrating individual on clinic,which may reduce the rate of catheter-associated with these complicationsMethods:We study on the incidence of catheter encrustation by case-comparison about 140 long-term catheterized cases who are exchanged catheter in our hospital from sep. to dec.2008 with cross section investigative method.We screening and analyzed the risk factors of catheter encrustation with non-condition Logistic regression,then construct regression model.Results:The survey of catheter complications recorded 140 long-term catheterized patients and showed that 43%experienced catheter encrustation,was not significantly different from that population prevalence 50%(P=0.108＞0.05),the group of the catheter replacing interval＞4 weeks is 57%,and the incidence of the daily mean urine volume≤2500ml is 60%.They are not significantly different from that population prevalence(P=0.366＞0.05,P=0.193＞0.05).The male and the female are respectively 44%and 33%(4/12).The silicone and siliconized-latex catheter are respectively 44 %and 30%(3/10).There are statistically significant difference between the both groups of catheter replacing interval＞4 weeks ands≤4 weeks,x~2=8.176, P＜0.01,and so between the both groups of daily mean urine volume≤2500ml and＞2500ml,x~2=9.196,P＜0.01.the incidence of catheter encrustation is associated with catheter replace interval and daily mean urine volume Primarily disease's distribution of two groups is not statistically significant, possessing comparability,x~2=11.099,P=0.520＞0.05.non-condition Logistic regression demonstrate that the catheter replacing interval is a risk factor,the more longer,the more danger,OR=1.486.High urine volume is a protection factor,the more higher of daily mean urine volume,the more safer,OR=0.753.The regression model:Logit(p)=—0.375+0.396X5—0.283X9.The incidence of catheter encrustation among the groups dividing by the variables of gender,age,position, indwelling time,quality nature,lockage,lavaging,etal are not statistically significant.Conclusion:The best interval of exchanging catheter is within 4 weeks.The appropriate urine quantity per day is over 2500ml.If we exchange the catheter over 4 weeks and the daily mean urine volume is under 2500ml,the incidence rate of catheter encrustation is the same as population prevalence.The critical point of exchanging catheter is 4 weeks,here if daily mean urine volume is over 2500ml,the incidence rate of catheter encrustation is lower than population prevalence.The critical point of daily mean urine volume is 2500ml,if we exchange the catheter within 4 weeks,the incidence rate of catheter encrustation is lower than population incidence too.Discriminant analysis of logistic regression with easily obtaining,cheap and manageable clinical data is helpful for cognition the close impact factors of catheter encrustation and forecast the possibility of avoiding catheter encrustation.Preventing the synthesis factors of catheter encrustation,carrying on some intervention measures and administrating individual will serve as a clinical guide of catheter replacing interval and daily mean urine volume.Only through these attempts,should we hope to enhance the living quality of patients.