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Urinary retention on an acute geriatric hospitalisation unit: prevalence, risk factors and the role of screening, an observational cohort study.

Authors
  • Fagard, Katleen1, 2
  • Hermans, Kasper3, 4
  • Deschodt, Mieke5, 6
  • Van de Wouwer, Sofie7
  • Vander Aa, Frank8
  • Flamaing, Johan9, 5
  • 1 Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium. [email protected] , (Belgium)
  • 2 Division of Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. [email protected] , (Belgium)
  • 3 Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. , (Netherlands)
  • 4 Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. , (Netherlands)
  • 5 Division of Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. , (Belgium)
  • 6 Healthcare and Ethics, Faculty of Medicine and Life Sciences, UHasselt, Hasselt, Belgium. , (Belgium)
  • 7 Department of Endocrinology, GZA Hospital, Campus Gasthuiszusters, Antwerp, Belgium. , (Belgium)
  • 8 Department of Urology, University Hospitals Leuven, Leuven, Belgium. , (Belgium)
  • 9 Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium. , (Belgium)
Type
Published Article
Journal
European geriatric medicine
Publication Date
Oct 01, 2021
Volume
12
Issue
5
Pages
1011–1020
Identifiers
DOI: 10.1007/s41999-021-00495-3
PMID: 33870476
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Urinary retention (UR) is common in older patients. The aim of this observational cohort study was to measure the prevalence of UR in patients aged ≥ 75 years on admission to an acute geriatric hospitalisation unit and to determine which at risk group would benefit from screening. Post-void residual volumes (PVR) were measured within 3 days of admission with an ultrasound bladder scan. Uni- and multivariable analysis were used to determine risk factors associated with PVR ≥ 150 and ≥ 300 millilitres. Ninety-four patients, mean age 84.6 years, were included. The male/female ratio was 0.7. Patients with PVR ≥ 150 (29.8%) had more urological comorbidities, symptoms of overflow incontinence, voiding difficulties, subtotal voiding, faecal impaction, urinary tract infection (UTI) and were more frequently referred because of urinary symptoms. Patients with PVR ≥ 300 lived less at home, had more urological comorbidities, dysuria, voiding difficulties, subtotal voiding, constipation, faecal impaction, UTI, detrusor relaxants, and were more frequently referred because of urinary symptoms. Voiding difficulties and referral because of urinary symptoms were independently associated with PVR ≥ 150. Not living at home, reporting subtotal voiding, constipation, and referral because of urinary symptoms were independently associated with PVR ≥ 300. Screening for UR on admission to an acute geriatric hospitalisation unit is most indicated in patients with urinary and defaecation problems. However, because the prevalence was high, because UR was also observed in patients without these problems, and history taking may be difficult, the threshold for PVR measurement in acutely ill geriatric patients should be low. Clinicaltrials.gov NTC04715971, January 19, 2021 (retrospectively registered). © 2021. The Author(s).

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