Preoperative Factors to Assess Risk for Postoperative Urinary Retention in Total Joint Arthroplasty: A Retrospective Analysis

被引:7
作者
Magaldi, Robert James [1 ,2 ]
Strecker, Sara Elaine [2 ,3 ]
Nissen, Carl W. [2 ]
Carangelo, Robert James [2 ]
Grady-Benson, John [2 ]
机构
[1] New York Inst Technol, Coll Osteopath Med, Old Westbury, NY USA
[2] Hartford Hosp, Bone & Joint Inst, Orthoped, Hartford, CT USA
[3] 31 Seymour St,Suite 202, Hartford, CT 06106 USA
来源
ARTHROPLASTY TODAY | 2022年 / 13卷
关键词
Post-operative urinary retention; Total joint arthroplasty; Catheterization; Risk factors; Post void residual; Bladder ultrasonography; TOTAL HIP; BLADDER CATHETERIZATION;
D O I
10.1016/j.artd.2021.10.009
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Postoperative urinary retention (POUR) is a significant problem in total joint arthroplasty (TJA). Although risk factors for POUR have been well documented, they are ubiquitous in an aging total joint population, which makes risk stratification difficult. The purpose of this study was to determine if a high preoperative post-void bladder scan identifies patients at risk for POUR.Methods: A retrospective analysis was conducted on all TJAs performed at a high-volume orthopedic center between December 2019 and February 2020. A total of 585 elective TJA patients received postvoid bladder scans before surgery. Bladder scan volumes were correlated with catheterization via Chisquared tests.Results: A high post-void residual volume (PVRV > 50 ml) was associated with an increased risk of catheterization (23% vs 34%, chi-squared statistic = 6.2638, P value = .013), as was intravenous fluid volume (>1000 ml in knee, >2000 ml in hip). Catheterization rates were higher among total knee arthroplasty patients younger than 60 years (37% vs 24%, chi-squared statistic = 4.284, P value = .0385) and total hip arthroplasty (THA) patients older than 65 years (30% vs 18%, chi-squared statistic = 3.292, P value = .0695). Multiple risk factors were additive. Conclusions: Higher PVRV and intravenous fluids were independently associated with catheterization after TJA. Younger age was associated with greater risk in total knee arthroplasty, while older age increased risk in THA. We propose that a preoperative bladder scan to detect a high PVRV may provide clinical utility to identify patients likely to develop POUR.(c) 2021 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons.
引用
收藏
页码:181 / 187
页数:7
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