Risk factors of acute urinary retention after spine surgery

Acute postoperative urinary retention (APOUR) is 1 of the most common complications of spinal surgery, impacting both postoperative care and the patients' quality of life. This study is designed to investigate the risk factors and the incidence of APOUR after spinal surgery in Taiwan. We conducted a retrospective analysis using the Taiwanese National Health Insurance Research Database (NHIRD), a nationwide cohort of patients who underwent spinal surgery from the year 2000 to 2013. Patients suffering from APOUR were collected and perioperative parameters were recorded. The risk factors related to APOUR after spinal surgery were examined using multivariate logistic regression analysis. A total of 16,160 patients who underwent spinal surgery were retrieved from NHIRD. Among them, 432 (2.67%) suffered from acute urinary retention after surgery. Multivariate logistic regression analysis revealed that age (adjusted odds ratio [OR] = 1.02, 95% CI = 1.01-1.02), male gender (adjusted OR = 1.35, 95% CI = 1.10-1.60) and undergoing spinal surgery more than 2 times (adjusted OR = 4.78, 95% CI = 2.49-9.20) were statistically significant risk factors for APOUR after spinal surgery. The results of this retrospective cohort study suggest that patients undergoing spinal surgery more than 2 times, male gender and advanced age are significantly associated with an increased risk of APOUR after spinal surgery. This information may assist surgeons to identify patients who have a high risk of APOUR after spinal surgery and proactively provide them with early intervention.