Validation of the Twenty-Four-Hour Threshold for Bladder Repair: Impact on Infection Rates Using the National Trauma Data Bank

Yu Chi Kuo, Chih Ying Chien, Pei Hua Li, Ting An Hsu, Chih Yuan Fu*, Francesco Bajani, Justin Mis, Stathis Poulakidas, Faran Bokhari

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Purpose: This study aimed to validate the previously reported association between delayed bladder repair and increased infection rates using the National Trauma Data Bank (NTDB). Methods: Bladder injury patients with bladder repair in the NTDB from 2013 to 2015 were included. Propensity score matching (PSM) was used to compare mortality, infection rates, and hospital length of stay (LOS) between patients who underwent bladder repair within 24 h and those who underwent repair after 24 h. Linear regression and multivariate logistic regression analyses were also performed. Results: A total of 1658 patients were included in the study. Patients who underwent bladder repair after 24 h had significantly higher infection rates (5.4% vs. 1.2%, p = 0.032) and longer hospital LOS (17.1 vs. 14.0 days, p = 0.032) compared to those who underwent repair within 24 h after a well-balanced 1:1 PSM (N = 166). Linear regression analysis showed a positive correlation between time to bladder repair and hospital LOS for patients who underwent repair after 24 h (B-value = 0.093, p = 0.034). Multivariate logistic regression analysis indicated that bladder repair after 24 h increased the risk of infection (odds = 3.162, p = 0.018). Subset analyses were performed on patients who underwent bladder repairs within 24 h and were used as a control group. These analyses showed that the time to bladder repair did not significantly worsen outcomes. Conclusions: Delayed bladder repair beyond 24 h increases the risk of infection and prolongs hospital stays. Timely diagnosis and surgical intervention remain crucial for minimizing complications in bladder injury patients.

Original languageEnglish
Pages (from-to)3116-3123
Number of pages8
JournalWorld Journal of Surgery
Issue number12
StatePublished - 12 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s) under exclusive licence to Société Internationale de Chirurgie.


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