Prospective Risk Factor Analysis for the Development of Post-operative Urinary Retention Following Ambulatory General Surgery
| Autor: | A. J. Langdon, K Moorthy, Bhavish Patel, Sam E Mason, Alasdair Scott, Erik Mayer, Sanjay Purkayastha |
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| Přispěvatelé: | Imperial College Healthcare NHS Trust- BRC Funding |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Laparoscopic surgery
Male medicine.medical_specialty Original Scientific Report medicine.medical_treatment 030232 urology & nephrology 03 medical and health sciences 0302 clinical medicine Postoperative Complications 030202 anesthesiology Lower urinary tract symptoms Risk Factors medicine Humans Prospective Studies Science & Technology Urinary retention business.industry General surgery Incidence Age Factors 1103 Clinical Sciences Perioperative Vascular surgery Middle Aged Urinary Retention medicine.disease Glycopyrrolate Ambulatory Surgical Procedures PREDICTIVE FACTORS Cardiothoracic surgery Elective Surgical Procedures Ambulatory Surgery Female Laparoscopy medicine.symptom business Factor Analysis Statistical Life Sciences & Biomedicine Abdominal surgery |
| Zdroj: | World Journal of Surgery |
| ISSN: | 1432-2323 0364-2313 |
| Popis: | Aims Post-operative urinary retention (POUR) is a common cause of unplanned admission following day-case surgery and has negative effects on both patient and surgical institution. We aimed to prospectively evaluate potential risk factors for the development of POUR following day-case general surgical procedures. Methods Over a 24-week period, consecutive adult patients undergoing elective day-case general surgery at a single institution were prospectively recruited. Data regarding urinary symptoms, comorbidities, drug history, surgery and perioperative anaesthetic drug use were collected. The primary outcome was the incidence of POUR, defined as an impairment of bladder voiding requiring either urethral catheterisation, unplanned overnight admission or both. Potential risk factors for the development of POUR were analysed by logistic regression. Results A total of 458 patients met the inclusion criteria during the study period, and data were collected on 382 (83%) patients (74.3% male). Sixteen patients (4.2%) experienced POUR. Unadjusted analysis demonstrated three significant risk factors for the development of POUR: age ≥ 56 years (OR 7.77 [2.18–27.78], p = 0.002), laparoscopic surgery (OR 3.37 [1.03–12.10], p = 0.044) and glycopyrrolate administration (OR 5.56 [2.00–15.46], p = 0.001). Male sex and lower urinary tract symptoms were not significant factors. Multivariate analysis combining type of surgery, age and glycopyrrolate use revealed that only age ≥ 56 years (OR 8.14 [2.18–30.32], p = 0.0018) and glycopyrrolate administration (OR 3.48 [1.08–11.24], p = 0.0370) were independently associated with POUR. Conclusions Patients aged at least 56 years and/or requiring glycopyrrolate—often administered during laparoscopic procedures—are at increased risk of POUR following ambulatory general surgery. Electronic supplementary material The online version of this article (10.1007/s00268-018-4697-4) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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