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Perioperative urinary retention, short‐term functional outcome and mortality rates of elderly hip fracture patients
Author(s) -
Adunsky Abraham,
Nenaydenko Olga,
KorenMorag Nira,
Puritz Lena,
Fleissig Yudit,
Arad Marina
Publication year - 2015
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12229
Subject(s) - medicine , urinary retention , hip fracture , functional independence measure , delirium , perioperative , retrospective cohort study , proportional hazards model , surgery , rehabilitation , physical therapy , osteoporosis , intensive care medicine
Aim Perioperative urinary retention ( POUR ) is common among hip fracture patients. The aim of the present study was to compare the prevalence, risk factors, functional outcomes and survival rates of patients with and without POUR . Methods This was a retrospective chart review study that was carried out in an orthogeriatric hip fracture unit. A total of 639 consecutive hip fracture patients who had hip surgery followed by a standard rehabilitation course participated in the study. Post‐void residual volume ( PVRV ), F unctional I ndependence M easure ( FIM ) scores (total and motor FIM , FIM gain) and mortality rates (90 and 365 days, end of follow up) were measured. Results A total of 328 patients (51.3%) suffered from POUR . Diabetes ( O R 1.55, 95% CI 1.04–2.31), urinary infection ( OR 3.25, 95% CI 2.16–4.90) and delirium ( O R 1.66. 95% CI 1.09–2.52) emerged as the best predictors for POUR . Functional gains were slightly better in patients without POUR ( P = 0.037 and P = 0.023, for discharge motor and total FIM gain, respectively). There were no differences in FIM gains at discharge in male patients, whether with or without POUR . However, female patients without POUR showed significantly better motor and total FIM gains on discharge ( P = 0.003 and P = 0.003, respectively), compared with females with POUR . In multiple linear regression analyses, POUR in female (but not male) patients was predictive for adverse motor FIM gain (beta = −0.089, P = 0.046). In Cox regression analysis, urinary retention was not associated with mortality rates. Conclusions POUR is highly prevalent in elderly hip fracture patients. It adversely affects the functional outcome of female patients, but is not associated with increased mortality rates. Geriatr Gerontol Int 2015; 15: 65–71.