The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1–4, respectively. We applied MAP criteria to statewide registry data to identify improvement targets.

Retrospective cohort study of risk-adjusted catheter use and duration for appendectomy, cholecystectomy, and colorectal resections in 2014–2015 from 64 Michigan hospitals.

5.5% of 13,032 Category A cases used urinary catheters, including 26.9% of open appendectomies. 94.5% of 1,624 Category B cases used catheters (31.2% remained after POD 1). 98.3% of 700 Category C cases used catheters (4.6% remained POD5+). Variation in duration of use persisted after risk adjustment.

Perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.

We applied perioperative urinary catheter appropriateness criteria to real world clinical data for appendectomy, cholecystectomy, and colorectal procedures. The 3 categories of appropriateness recommended: (A) avoid urinary catheter if possible; (B) consider removing catheter before leaving the operating room, or on postoperative day (POD) 1; and (C) appropriate to use until at least POD1. Perioperative urinary catheter use was appropriate for most simple abdominal procedures, but duration of use varied in all categories.