Trial without a Catheter Programme Improves Urological Management for Retention of Urine after Hip Fracture Surgery
| Autor: | Chin Ping-Hong Raymond, Cheng Kin-Hung William |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Hip fracture business.industry Urinary system Rehabilitation Urethral Catheters 030232 urology & nephrology Physical Therapy Sports Therapy and Rehabilitation Retrospective cohort study Hip fracture surgery Urine medicine.disease Surgery lcsh:RD701-811 03 medical and health sciences Catheter 0302 clinical medicine lcsh:Orthopedic surgery 030502 gerontology medicine Orthopedics and Sports Medicine Catheter removal 0305 other medical science business |
| Zdroj: | Journal of Orthopaedics, Trauma and Rehabilitation, Vol 21 (2016) |
| ISSN: | 2210-4925 2210-4917 |
| Popis: | Background Acute retention of urine (AROU) is commonly occurred in patients with geriatric hip fractures after surgeries. It is common that the catheters cannot be weaned off after insertion. Objectives We compared an approach using unified Trial Without Catheter (TWOC) protocol with non-unified management plans in patients with retention of urine after hip fracture surgery, to compare these approaches in terms of (1) rate of successful catheter removal, (2) duration required for successful catheter removal, (3) number of episodes of urinary tract infection, and (4) length of hospital stay. Methods We conducted a retrospective cohort study of 250 patients who failed to wean off a urinary catheter. 140 out of 1349 patients between December 2012 and September 2014 formed the intervention group (treated with unified TWOC protocol), and 110 out of 1193 patients between July 2006 and December 2008 were the control group (treated with different AROU management approaches). The efficiency and effectiveness of the urological management in both groups were compared. Results As expected, the rate of successful TWOC was higher in intervention group (before discharge, 68.6% versus 38.2%; after discharge, 20.0% versus 18.2%, overall, 88.6% versus 56.4%). Despite trial of weaning off urinary catheters, 16 patients in intervention group and 8 patients in control group failed with permanent catheter required. Forty patients in control group were discharged with permanently catheters without a trial of TWOC. Conclusion The TWOC program provides structured and standardized urological management for patients suffered from AROU after geriatric hip fracture surgeries. To reiterate, indwelling urethral catheters must not be placed permanently without carrying out urological assessment in patients with geriatric hip fractures. |
| Databáze: | OpenAIRE |
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