A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty

Joseph J. Hejkal, Taylor M. Ditoro, Rachel E. Thompson, Robin R. High, Kristy J. Carlson, Jason F. Shiffermiller

Research output: Contribution to journalArticlepeer-review

Abstract

Background: 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. Methods: 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. Results: 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). Conclusion: Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA.

Original languageEnglish (US)
Pages (from-to)232-238
Number of pages7
JournalJournal of Arthroplasty
Volume38
Issue number2
DOIs
StatePublished - Feb 2023
Externally publishedYes

Keywords

  • cholinergic antagonists
  • early ambulation
  • total joint arthroplasty
  • urinary catheterization
  • urinary retention

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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