A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty
Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections. Studies have found that certain anticholinergic medications and reduced mobility are associated with POUR. This study as...
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| Veröffentlicht in: | The Journal of arthroplasty 2023-02, Vol.38 (2), p.232-238 |
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| creator | Hejkal, Joseph J. Ditoro, Taylor M. Thompson, Rachel E. High, Robin R. Carlson, Kristy J. Shiffermiller, Jason F. |
| description | Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections. Studies have found that certain anticholinergic medications and reduced mobility are associated with POUR. This study assessed the effect of anticholinergic burden and later postoperative ambulation on POUR.
In this retrospective cohort study, we included subjects who had undergone elective primary or revision hip or knee arthroplasty (total hip arthroplasty [THA] or total knee arthroplasty [TKA]) between March 2015 and December 2017 in a single health system. Anticholinergic burden was measured using the Anticholinergic Drug Scale (ADS). We performed bivariate and multivariable logistic regression with POUR as the dependent variable. Of the 1,397 study subjects, 622 (45%) underwent THA and 775 (55%) underwent TKA. Their mean age was 65 years (range, 21 to 98), and 841 (60%) were women. POUR developed in 183 (13%) subjects.
In multivariable analyses, ADS was associated with POUR after THA (P < .05), but not TKA (P = .08), while later ambulation was not associated with POUR after either procedure (P > .3 for both).
Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA. |
| doi_str_mv | 10.1016/j.arth.2022.08.027 |
| format | Article |
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In this retrospective cohort study, we included subjects who had undergone elective primary or revision hip or knee arthroplasty (total hip arthroplasty [THA] or total knee arthroplasty [TKA]) between March 2015 and December 2017 in a single health system. Anticholinergic burden was measured using the Anticholinergic Drug Scale (ADS). We performed bivariate and multivariable logistic regression with POUR as the dependent variable. Of the 1,397 study subjects, 622 (45%) underwent THA and 775 (55%) underwent TKA. Their mean age was 65 years (range, 21 to 98), and 841 (60%) were women. POUR developed in 183 (13%) subjects.
In multivariable analyses, ADS was associated with POUR after THA (P < .05), but not TKA (P = .08), while later ambulation was not associated with POUR after either procedure (P > .3 for both).
Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2022.08.027</identifier><identifier>PMID: 36007754</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; cholinergic antagonists ; early ambulation ; Female ; Humans ; Lower Extremity ; Male ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies ; Risk Factors ; total joint arthroplasty ; urinary catheterization ; Urinary Catheterization - adverse effects ; urinary retention ; Urinary Retention - chemically induced ; Urinary Retention - epidemiology</subject><ispartof>The Journal of arthroplasty, 2023-02, Vol.38 (2), p.232-238</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-f61789a9b8c47e0d568d6761fdc3298177c2fd1ffb0a3dc272ece33c892a79893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540322007835$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36007754$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hejkal, Joseph J.</creatorcontrib><creatorcontrib>Ditoro, Taylor M.</creatorcontrib><creatorcontrib>Thompson, Rachel E.</creatorcontrib><creatorcontrib>High, Robin R.</creatorcontrib><creatorcontrib>Carlson, Kristy J.</creatorcontrib><creatorcontrib>Shiffermiller, Jason F.</creatorcontrib><title>A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections. Studies have found that certain anticholinergic medications and reduced mobility are associated with POUR. This study assessed the effect of anticholinergic burden and later postoperative ambulation on POUR.
In this retrospective cohort study, we included subjects who had undergone elective primary or revision hip or knee arthroplasty (total hip arthroplasty [THA] or total knee arthroplasty [TKA]) between March 2015 and December 2017 in a single health system. Anticholinergic burden was measured using the Anticholinergic Drug Scale (ADS). We performed bivariate and multivariable logistic regression with POUR as the dependent variable. Of the 1,397 study subjects, 622 (45%) underwent THA and 775 (55%) underwent TKA. Their mean age was 65 years (range, 21 to 98), and 841 (60%) were women. POUR developed in 183 (13%) subjects.
In multivariable analyses, ADS was associated with POUR after THA (P < .05), but not TKA (P = .08), while later ambulation was not associated with POUR after either procedure (P > .3 for both).
Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA.</description><subject>Aged</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>cholinergic antagonists</subject><subject>early ambulation</subject><subject>Female</subject><subject>Humans</subject><subject>Lower Extremity</subject><subject>Male</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>total joint arthroplasty</subject><subject>urinary catheterization</subject><subject>Urinary Catheterization - adverse effects</subject><subject>urinary retention</subject><subject>Urinary Retention - chemically induced</subject><subject>Urinary Retention - epidemiology</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1uEzEYRS0EoqHwAiyQl2xm8M_M2COxGVUtPwpCKmRtOfZn6jCxg-20hCfhcXGawpKVLfncK10fhF5S0lJChzebVqdy0zLCWEtkS5h4hBa056yRHRkeowWRkjd9R_gZepbzhhBK-757is74QIgQfbdAvyd8DSXFvANT_C3gL2VvDzg6PIXizU2cfYD0zRu8yoB1sHipCyT8Ka797H_p4mPAOuNrn7_jK21KTBm7mPAq-aDT4dgO4Z6a3H1Qb-rrMt7V--XPkmDrywF_jD4UPNU5Ke5mncvhOXri9JzhxcN5jlZXl18v3jfLz-8-XEzLxnAiSuMGKuSox7U0nQBi-0HaQQzUWcPZKKkQhjlLnVsTza1hgoEBzo0cmRajHPk5en3q3aX4Yw-5qK3PBuZZB4j7rJggtW4ceFdRdkJN_a-cwKld8ts6UlGijkbURh2NqKMRRaSqRmro1UP_fr0F-y_yV0EF3p4AqCtvPSSVjYdgwPpUnSgb_f_6_wDh95-l</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Hejkal, Joseph J.</creator><creator>Ditoro, Taylor M.</creator><creator>Thompson, Rachel E.</creator><creator>High, Robin R.</creator><creator>Carlson, Kristy J.</creator><creator>Shiffermiller, Jason F.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202302</creationdate><title>A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty</title><author>Hejkal, Joseph J. ; Ditoro, Taylor M. ; Thompson, Rachel E. ; High, Robin R. ; Carlson, Kristy J. ; Shiffermiller, Jason F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-f61789a9b8c47e0d568d6761fdc3298177c2fd1ffb0a3dc272ece33c892a79893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>cholinergic antagonists</topic><topic>early ambulation</topic><topic>Female</topic><topic>Humans</topic><topic>Lower Extremity</topic><topic>Male</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>total joint arthroplasty</topic><topic>urinary catheterization</topic><topic>Urinary Catheterization - adverse effects</topic><topic>urinary retention</topic><topic>Urinary Retention - chemically induced</topic><topic>Urinary Retention - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hejkal, Joseph J.</creatorcontrib><creatorcontrib>Ditoro, Taylor M.</creatorcontrib><creatorcontrib>Thompson, Rachel E.</creatorcontrib><creatorcontrib>High, Robin R.</creatorcontrib><creatorcontrib>Carlson, Kristy J.</creatorcontrib><creatorcontrib>Shiffermiller, Jason F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hejkal, Joseph J.</au><au>Ditoro, Taylor M.</au><au>Thompson, Rachel E.</au><au>High, Robin R.</au><au>Carlson, Kristy J.</au><au>Shiffermiller, Jason F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2023-02</date><risdate>2023</risdate><volume>38</volume><issue>2</issue><spage>232</spage><epage>238</epage><pages>232-238</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections. Studies have found that certain anticholinergic medications and reduced mobility are associated with POUR. This study assessed the effect of anticholinergic burden and later postoperative ambulation on POUR.
In this retrospective cohort study, we included subjects who had undergone elective primary or revision hip or knee arthroplasty (total hip arthroplasty [THA] or total knee arthroplasty [TKA]) between March 2015 and December 2017 in a single health system. Anticholinergic burden was measured using the Anticholinergic Drug Scale (ADS). We performed bivariate and multivariable logistic regression with POUR as the dependent variable. Of the 1,397 study subjects, 622 (45%) underwent THA and 775 (55%) underwent TKA. Their mean age was 65 years (range, 21 to 98), and 841 (60%) were women. POUR developed in 183 (13%) subjects.
In multivariable analyses, ADS was associated with POUR after THA (P < .05), but not TKA (P = .08), while later ambulation was not associated with POUR after either procedure (P > .3 for both).
Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36007754</pmid><doi>10.1016/j.arth.2022.08.027</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects cholinergic antagonists early ambulation Female Humans Lower Extremity Male Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Risk Factors total joint arthroplasty urinary catheterization Urinary Catheterization - adverse effects urinary retention Urinary Retention - chemically induced Urinary Retention - epidemiology |
| title | A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty |
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