Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke.
Shu-Chuan Chen, Pei-Ya Chen, Guei-Chiuan Chen and 3 others
PMID 29851660WHAT IT FOUND
In the period when portable bladder ultrasound was available, stroke patients had fewer UTIs (4.0% vs 6.9%) and hospital stays 1.7 days shorter, but only 31% of that group received scanning.
Key findings
01When portable bladder ultrasound was available, UTI occurred in 4.0% of patients versus 6.9% when unavailable, and average length of stay was 1.7 days shorter.
02Portable bladder ultrasound was performed for only 31% of patients in the scanner-available group; among those scanned, 97 had postvoid residual urine volume of 100 mL or greater and 18 were catheterized.
03UTI and unfavorable outcomes shared predictors: age 75 years or older, female gender, total NIHSS score 5 or higher, NIHSS conscious score 1 or higher, NIHSS leg score 2 or higher, and urinary catheterization.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective chart review, not a randomised trial, so it cannot prove portable bladder ultrasound caused the lower UTI rate or shorter stay. The scanner was introduced over time, and the study did not include many medical parameters, such as hypertension, diabetes, hyperlipidemia, prostate history, stroke type, or infarct location. Only 31% of patients in the scanner period received scanning, and selection depended on relaxed bedside criteria rather than a fixed protocol. The scanner period patients were older on average by 1.6 years, had a lower percentage of female patients, and had more urinary catheterization, all of which can affect UTI risk. Portable bladder ultrasound was performed by various bedside nurses, and the authors expected detection errors. The study did not compare stroke location or infarct size with urinary dysfunction patterns. Discharge stroke severity, daily living, and disability scores did not differ between periods, so the scanner period did not show better functional recovery.
Declared interests
The authors report no conflicts of interest to disclose. No specific funder or sponsor role is named in the article text.
The easy way to misread this
Do not read the lower UTI rate and shorter stay as proof that portable bladder ultrasound alone prevented infections. The study compared a later period with scanner availability to an earlier period, only 31% of the later group received scanning, and the groups differed in age, female percentage, and catheterization, so the scanner cannot be separated from other period differences.