title: Perioperative urinary retention, short-term functional outcome and mortality rates of elderly hip fracture patients.
abstract: OBJECTIVE
  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), Functional Independence Measure (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 (OR 1.55, 95% CI 1.04-2.31), urinary infection (OR 3.25, 95% CI 2.16-4.90) and delirium (OR 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.
authors.affiliation: Department of Geriatric Medicine and Rehabilitation, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel; The Orthogeriatric Hip Fracture Unit, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Adunsky
authors.forename: Olga
authors.initials: O
authors.lastname: Nenaydenko
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: Lena
authors.initials: L
authors.lastname: Puritz
authors.forename: Yudit
authors.initials: Y
authors.lastname: Fleissig
authors.forename: Marina
authors.initials: M
authors.lastname: Arad
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D014554:Urination / Q000502:physiology*
keywords: elderly; hip fracture; orthogeriatric; perioperative; urine retention