Very elderly women are at high risk for inappropriate urinary catheter (UC) use in the emergency department (ED), according to researchers.

Mohamad G. Fakih, MD, MPH, of St. John Hospital and Medical Center in Detroit, and colleagues evaluated 4,521 patients admitted through that facility’s ED. Women accounted for 2,443 (54%) of these patients, but they represented 63% of patients who had a UC placed.

A UC was placed in 532 patients (11.8%). Of these UCs, 371 (69.7%) were indicated and 312 (58.6%) had a physician’s order documented. The mean age of the patients who had a UC placed without an indication was 71.3 years versus 60 years for patients with an indication and 56.2 years for patients who did not have a UC placed.

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In addition, half of the women aged 80 years and older who had a UC placed did not have an indication according to the institution’s guidelines, the investigators reported in the American Journal of Infection Control (2010;38:683-688). Women were nearly twice as likely as men to have catheter placed without an indication. The risk was nearly three times greater for patients aged 80 years or older compared with those aged 50 years or younger.

“Our findings can help identify groups at increased risk for inappropriate UC placement in the ED in the presence of clear institutional guidelines,” the authors noted.