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 ( < .05), but not TKA ( = .08), while later ambulation was not associated with POUR after either procedure ( > .3 for both). Anticholinergic burden after THA was independently associated with POUR. Strategies to reduce anticholinergic burden may help reduce POUR after THA.

中文翻译：

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抗胆碱能药物的使用和后期活动作为重大下肢关节置换术后尿潴留危险因素的回顾性研究

术后尿潴留（POUR）是主要关节置换术的常见手术并发症，与住院时间延长和尿路感染有关。研究发现，某些抗胆碱能药物和活动能力下降与 POUR 相关。本研究评估了抗胆碱能负荷和术后术后活动对 POUR 的影响。在这项回顾性队列研究中，我们纳入了 2015 年 3 月至 2017 年 12 月期间在单一卫生系统中接受过选择性初次或翻修髋关节或膝关节置换术（全髋关节置换术 [THA] 或全膝关节置换术 [TKA]）的受试者。使用抗胆碱能药物量表（ADS）测量抗胆碱能负荷。我们以 POUR 作为因变量进行双变量和多变量逻辑回归。在 1,397 名研究对象中，622 名 (45%) 接受了 THA，775 名 (55%) 接受了 TKA。他们的平均年龄为 65 岁（范围为 21 岁至 98 岁），其中 841 名 (60%) 为女性。 183 名受试者 (13%) 出现了 POUR。在多变量分析中，ADS 与 THA 后的 POUR 相关（< .05），但与 TKA 无关（= .08），而后期下床活动与任一手术后的 POUR 均无关（均 > .3）。 THA 后的抗胆碱能负担与 POUR 独立相关。减少抗胆碱能负担的策略可能有助于减少 THA 后的 POUR。