Early Morbidity of Suprapubic Catheter Insertion: Increased Comorbidity Portends Increased Risk

To evaluate the complication rate of suprapubic catheter (SPC) placement as well as the impact of patient comorbidity on SPC related perioperative and 90-day complications, emergency department (ED) visits, and hospital admission.

Retrospective review identified all adult patients who underwent SPC from 2014 to 2019 at a single institution. Age-adjusted Charlson Comorbidity Index score (CCI) was calculated in each patient. Logistic regression was used to explore the association between potential risk factors and the odds of perioperative (within 72 h) and 90-day complications, ED visit and hospital admission. Kaplan Meir curves assessed complication free survival (CFS) and multivariable Cox regression was used to assess the impact of comorbidity.

222 SPCs, performed by 21 surgeons, were included. Median patient age: 66 years (IQR 50-77), BMI: 26 (IQR 23-30), and CCI: 4.0 (IQR 1-4). 31% resulted in ≥ 1 complication within 90-days (7% perioperative), 15% in ED visit and 8% in admission. Increasing CCI score was associated with significantly increased odds of all four outcomes (all p < 0.05). Multivariable Cox regression demonstrated that increasing CCI was significantly associated with an increased risk of SPC-related 90-day morbidity (HR 1.1; p = 0.04), Table 3.

Increased comorbidity portends increased risk of postoperative complication. This finding is critical for adequately counseling patients, particularly the sick and elderly, and families when considering SPC.