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Elevated post-void residual volume in a geriatric post-hip fracture assessment in women-associated factors and risk of mortality

  • Maria S. Nuotio
  • Tiina Luukkaala
  • Teuvo Tammela
Original Article

Abstract

Background and Aim

Multiple factors contribute to elevated post-void residual urine volumes (PVR), but they may indicate detrusor underactivity (DU), especially in older women. The aim here was to examine factors associated with and prognostic significance of elevated PVR in a geriatric post-hip fracture assessment in a female population.

Methods

Consecutive female hip fracture patients (n = 409) aged 65 years and older were included. PVR was measured by bladder scanner. PVR of 160 ml or more was deemed elevated. Age-adjusted univariate logistic regression analyses were conducted to examine the association of the domains of the comprehensive geriatric assessment (CGA) with elevated PVR. Cox proportional hazards model was used to determine the age-adjusted association of an elevated PVR with 1-year mortality.

Results

Of the patients, 64 (15.6%) had elevated PVR. Having urinary or fecal incontinence, difficulties in physical activities of daily living, malnutrition, poor performance on Timed Up and Go and Elderly Mobility Scale were significantly associated with elevated PVR. Difficulties in instrumental activities of daily living, renal dysfunction, constipation, polypharmacy, nocturia, cognitive impairment and depressive mood were not associated with elevated PVR. Elevated PVR significantly increased the risk of mortality 1 year post hip fracture.

Conclusions

Elevated PVR is relatively common in older female hip fracture patients and associated with physical functioning, malnutrition and risk of mortality. Even though a causal relationship cannot be confirmed, the findings may suggest a relationship between DU and physical frailty. PVR deserves to be included in the CGA of frail older patients including women.

Keywords

Detrusor underactivity Post-void residual Hip fracture Physical functioning Geriatric assessment 

Notes

Acknowledgements

Ms Kaisu Haanpää, RN, is gratefully acknowledged for her expert collecting and saving of the data.

Funding

This work was supported by Research Fund of the Hospital District of Southern Ostrobothnia and the State Research Financing of Seinäjoki Central Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study design was approved by the Ethics Committee of the Hospital District of Southern Ostrobothnia. The study complies with the ethical standards of the Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all the participants or their representatives.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maria S. Nuotio
    • 1
  • Tiina Luukkaala
    • 2
    • 3
  • Teuvo Tammela
    • 4
    • 5
  1. 1.Department of Geriatric MedicineSeinäjoki Central HospitalSeinäjokiFinland
  2. 2.Science CenterPirkanmaa Hospital DistrictTampereFinland
  3. 3.School of Health SciencesUniversity of TampereTampereFinland
  4. 4.Department of Surgery, Faculty of Medicine and Life SciencesUniversity of TampereTampereFinland
  5. 5.Tampere University HospitalTampereFinland

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