Fecal impaction is associated with postoperative urinary retention after hip fracture surgery - 14/12/21
, Lorène Zerah a, Audrey Rouet a, Charlotte Tomeo a, Marc Verny a, Judith Cohen-Bittan a, Jacques Boddaert a, c, Rebecca Haddad b, d, e
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Highlights |
• | Post-operative urinary retention (POUR) is frequent after a hip fracture surgery. |
• | POUR negatively impacts functional recovery in older adults. |
• | To date, the role of fecal impaction in POUR was uncertain. |
• | Fecal impaction was the only independent risk factor of POUR. |
• | These findings are critical and could improve the recovery of these patients. |
Abstract |
Background |
Postoperative urinary retention (POUR) is a common hip fracture (HF) complication. Although fecal impaction (FI) is one of the oft-cited causes of POUR in clinical practice, evidence regarding this association is scarce.
Objective |
The aim of this study was to determine whether FI was associated with POUR after HF surgery in older patients.
Methods |
All patients consecutively admitted after a HF surgery in a geriatric perioperative unit were included in this cross-sectional study. FI was systematically assessed by a digital rectal exam at admission and according to clinical suspicion during the hospital stay. The dependent variable was POUR, systematically screened according to the department protocol and defined as a bladder volume>400ml requiring catheterization. The association between FI and POUR was assessed by multivariable analysis.
Results |
A total of 256 patients were included (mean [SD] age 86 [6] years), (76% women): 108 (42%) presented FI and 63 (25%) POUR. The frequency of FI was higher with than without POUR (73% vs. 32%, P<0.001). On multivariable analysis, after adjusting for age, sex, Cumulative Illness Rating Scale score and anticholinergic load, FI was the only factor independently associated with POUR (odds ratio 4.78) [95% confidence interval 2.44-9.71], P<0.001.
Conclusions |
FI was the only independent factor associated with POUR after HF surgery in older adults. Further studies are needed to optimize perioperative geriatric care including FI and POUR assessment and management.
Le texte complet de cet article est disponible en PDF.Keywords : Post-operative urinary retention, Fecal impaction, Hip fracture, Older, Lower urinary tract symptoms, Rehabilitation
Plan
Vol 64 - N° 6
Article 101464- novembre 2021 Retour au numéro
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