Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Department of Urology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Medicine (Baltimore). 2024 Nov 29;103(48):e40708. doi: 10.1097/MD.0000000000040708.
Acute postoperative urinary retention (APOUR) is 1 of the most common complications of spinal surgery, impacting both postoperative care and the patients' quality of life. This study is designed to investigate the risk factors and the incidence of APOUR after spinal surgery in Taiwan. We conducted a retrospective analysis using the Taiwanese National Health Insurance Research Database (NHIRD), a nationwide cohort of patients who underwent spinal surgery from the year 2000 to 2013. Patients suffering from APOUR were collected and perioperative parameters were recorded. The risk factors related to APOUR after spinal surgery were examined using multivariate logistic regression analysis. A total of 16,160 patients who underwent spinal surgery were retrieved from NHIRD. Among them, 432 (2.67%) suffered from acute urinary retention after surgery. Multivariate logistic regression analysis revealed that age (adjusted odds ratio [OR] = 1.02, 95% CI = 1.01-1.02), male gender (adjusted OR = 1.35, 95% CI = 1.10-1.60) and undergoing spinal surgery more than 2 times (adjusted OR = 4.78, 95% CI = 2.49-9.20) were statistically significant risk factors for APOUR after spinal surgery. The results of this retrospective cohort study suggest that patients undergoing spinal surgery more than 2 times, male gender and advanced age are significantly associated with an increased risk of APOUR after spinal surgery. This information may assist surgeons to identify patients who have a high risk of APOUR after spinal surgery and proactively provide them with early intervention.
急性术后尿潴留（APOUR）是脊柱手术后最常见的并发症之一，影响术后护理和患者的生活质量。本研究旨在探讨台湾地区脊柱手术后 APOUR 的危险因素和发生率。我们使用台湾全民健康保险研究数据库（NHIRD）进行回顾性分析，该数据库是一个 2000 年至 2013 年接受脊柱手术的全国性患者队列。收集发生 APOUR 的患者，并记录围手术期参数。使用多变量逻辑回归分析检查与脊柱手术后 APOUR 相关的危险因素。从 NHIRD 中检索到 16160 名接受脊柱手术的患者。其中，432 名（2.67%）患者术后发生急性尿潴留。多变量逻辑回归分析显示，年龄（调整优势比[OR] = 1.02，95%CI = 1.01-1.02）、男性（调整 OR = 1.35，95%CI = 1.10-1.60）和脊柱手术次数超过 2 次（调整 OR = 4.78，95%CI = 2.49-9.20）是脊柱手术后发生 APOUR 的统计学显著危险因素。这项回顾性队列研究的结果表明，脊柱手术次数超过 2 次、男性和高龄与脊柱手术后发生 APOUR 的风险增加显著相关。这些信息可能有助于外科医生识别脊柱手术后发生 APOUR 风险较高的患者，并主动为他们提供早期干预。
