Relation of postvoid residual to urinary tract infection during stroke rehabilitation

Objectives: To examine (1) risk factors for urinary tract infection (UTI) during stroke rehabilitation and (2) the relation of postvoid residual (PVR) to the frequency of UTI. Design: Prospective case series. Setting: Academic specialty stroke rehabilitation service. Participants: One hundred one consecutive admissions for stroke rehabilitation. Interventions: Not applicable. Main Outcome Measure: Presence or absence of UTI. Results: Previously undiagnosed UTI was found in 28 of 101 subjects. Two or more PVR determinations of 150mL or more were an independent risk factor for UTI. In multivariate analysis, factors associated with increased risk of UTI included only use of beta-blockers and 2 peak PVR determinations of 150mL or more. Single determinations were not significant. Conclusion: The optimal PVR for initiating bladder catheterization during stroke rehabilitation remains unknown, but the risk of UTI increases only when 2 or more ultrasound PVR readings are more than 150mL.