Incidence and risk factors for postoperative urinary retention in older patients with hip fracture: a scoping review

This scoping review aimed to synthesise the currently available evidence and influencing factors on the occurrence of postoperative urinary retention (POUR) in older patients with hip fractures.

This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline.

PubMed, Cochrane Library, CINAHL, Web of Science, Chinese National Knowledge Infrastructure, Wanfang Data and Sinomed databases were systematically searched from database inception to 1 September 2024.

We included observational studies reporting on POUR prevalence and risk factors among patients aged 60 years and older with hip fractures and excluded systematic and non-systematic reviews, conference proceedings, editorials, commentaries, qualitative studies and case studies. Duplicated articles and articles unable to access the full text were also excluded. We also excluded studies with populations with pathologic fractures, multiple fractures, treated for periprosthetic fracture, or if studies were published in a language other than English and Chinese.

Two authors independently extracted and summarised the data. We summarised the prevalence and risk factors for POUR in older patients with hip fractures.

A total of 106 studies were identified, and 12 studies (all from published literature sources) detailing POUR prevalence and risk factors were included. The studies showed that the incidence of POUR in older patients with hip fractures ranged from 11.10% to 51.33%, and the risk factors included impaired activities of daily living, use of anticholinergic medications, serological indicators (serum albumin and thyroid-stimulating hormone), complications (urinary infection and postoperative incontinence), prolonged indwelling urinary catheters and faecal impaction. In addition, male sex, cognitive impairment, use of opioid medications and coexisting diabetes may also be risk factors for POUR, which still needs to be further clarified CONCLUSION: The incidence of POUR in older patients with hip fractures varies widely. Most factors were reported in one study with no proposed underlying mechanism for their influence. Further high-quality studies are needed to validate these findings.