Xia Jinghua, Zhao Dan, Hu Yanzhen, Wang Shuangshuang, Lu Xuemei
Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
BMJ Open. 2025 Sep 5;15(9):e100368. doi: 10.1136/bmjopen-2025-100368.
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.
本综述旨在综合目前关于老年髋部骨折患者术后尿潴留（POUR）发生情况的现有证据及影响因素。
本综述按照系统评价与Meta分析扩展版的范围综述报告规范进行。
从数据库建库至2024年9月1日，对PubMed、Cochrane图书馆、CINAHL、科学引文索引、中国知网、万方数据和中国生物医学文献数据库进行系统检索。
我们纳入了报告60岁及以上髋部骨折患者POUR患病率和危险因素的观察性研究，排除了系统评价和非系统评价、会议论文集、社论、评论、定性研究和病例研究。重复发表的文章以及无法获取全文的文章也被排除。我们还排除了研究对象为病理性骨折、多发骨折、假体周围骨折患者的研究，以及非英文和中文发表的研究。
两位作者独立提取并汇总数据。我们总结了老年髋部骨折患者POUR的患病率和危险因素。
共检索到106项研究，纳入12项（均来自已发表文献）详细阐述POUR患病率和危险因素的研究。研究表明，老年髋部骨折患者POUR的发生率在11.10%至51.33%之间，危险因素包括日常生活活动能力受损、使用抗胆碱能药物、血清学指标（血清白蛋白和促甲状腺激素）、并发症（泌尿系统感染和术后尿失禁）、留置尿管时间延长和粪便嵌塞。此外，男性、认知障碍、使用阿片类药物和并存糖尿病也可能是POUR的危险因素，这仍需进一步明确。结论：老年髋部骨折患者POUR的发生率差异很大。大多数因素仅在一项研究中被报道，且未提出其影响的潜在机制。需要进一步开展高质量研究以验证这些发现。
