Presentation Authors: Conor Mosli-Lynch*, David Barton-Grimley, LONDON, United Kingdom
Introduction: In the USA there are an estimated 2 million patients with a long-term urinary catheter. The majority of these patients are elderly, frail and living in the community. Urinary catheters are prone to complications including blockage, infection and haematuria. Catheter outputs are poorly monitored and approximately 40% of catheterised patients attend hospital at least once a year with a catheter-associated complication. These represent a significant burden on the healthcare system. We have developed a device that fits between the catheter and the drainage bag that continuously records urine output and transmits it to a cloud based system. The data are then analysed, complications are identified early and the appropriate clinician can be alerted. This paper reports on the results of a trial that demonstrates the ability of the device to identify catheter-related complications in comparison to current methods.
Methods: This bench trial was conducted to compare the ability of the device to correctly identify three properties of urine: Urine Specific Gravity (USG), Haematuria and Infection. 120 patient samples were taken and graded from 0-5 by conventional means of urine analysis. USG was ascertained via dipstick analysis and graded 0-5 with 0 being USG less than 1.005 and 5 being greater than 1.025. Haematuria was measured by a combination of dipstick and visual analogue score, with 0 being dipstick negative and 5 being frank haematuria with clots. Infection was also measured in a similar manner with 0 being dipstick negative and 5 being cloudy, turgid urine. These samples were then fed through a standard foley catheter at a rate of approximately 1ml/min where they were electronically analysed by the device and recorded. The results were then graphed and compared to the initial 'bedside' analysis. Comparative statistical analysis was performed via the Chi-Squared Test.
Results: Statistical analysis showed that the device was able to identify gross changes in urine for each of the three variables, p < 0.05 for all three. It was more consistent at identifying gradual changes in USG and haematuria than in infection. It was limited however in identifying multivariant characteristics (ie gross haematuria with infection) but we are confident that further analysis of a greater array of samples in addition to more advanced analytical techniques will improve this.
Conclusions: This trial concludes that the device can identify catheter related complications with a similar accuracy to conventional 'bedside' methods. It's intended use is to monitor elderly catheterised patients and alert their doctors and carers to potential problems and we believe that this trial shows it has the potential to be of benefit. A multi-center trial is currently recruiting in order to show the clinical predictive value of continuous urine monitoring.
Source of Funding: The device was self funded by the authors.