title: A prospective study of urinary retention and risk of death after proximal femoral fracture.
abstract: Older age, dementia syndrome and impaired mobility are well recognized risk factors for fatality after fracture of the proximal femur. Urinary retention is recognized as a common complication of elective total hip replacement. In this investigation, we estimated the incidence of urinary retention associated with hip fracture in older women and assessed its relationship to 2-year post-operative fatality. Over a 7-month period, 309 women aged 65 and over were admitted to one trauma unit with hip fracture. Readings of post-voiding residual volume were taken on admission (pre-operative), within 24 hours of operation (post-operative) and 5-7 days post-operatively (recovery). Of the 309 patients, 244 (79%) had readings of post-voiding residual volume taken on admission; 90/244 (37%) had retention pre-operatively, 122/216 (56%) post-operatively and 40/183 (22%) in the recovery phase. One year after operation 305 patients were traced and median follow-up was 2 years. Older age, cognitive impairment, polypharmacy, impaired mobility and urinary retention on admission and during recovery were associated with a higher fatality in the first post-operative year. Pre-operative urinary retention is common among older women with proximal femoral fracture and affects over half post-operatively. Retention is one of several factors associated with higher fatality.
authors.affiliation: Department of Health Care of the Elderly, University Hospital, Nottingham.
authors.forename: N K
authors.initials: NK
authors.lastname: Smith
authors.forename: M K
authors.initials: MK
authors.lastname: Albazzaz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000401:mortality* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D015996:Survival Rate; D016055:Urinary Retention / Q000209:etiology / Q000401:mortality*