Hip fractures (HFs) are considered a severe health hazard for the aged population and one of the most common geriatric disorders [1]. HF significantly impacts morbidity, with 30‒50% of patients losing their ability to function independently, and mortality, with a 22% mortality rate the first year after HF [1]. Age and the female gender are risk factors for this condition [1, 2]. The prevalence of HF among people aged 50 years and older varies widely across the globe, ranging from more than 500 cases per 100,000 adults (in Denmark) to under 100 cases per 100,000 adults (e.g., South Africa) [3]. In Spain, the National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera, or RNFC) reported a total of 10,068 HF cases in 2021, of which 33% corresponded to individuals between 75 and 84 years, 57% to individuals between 85 and 94 years, and 9.2% to individuals over 94 years [4]. Regarding gender differences, the most recent RNFC report showed that 75.4% of registered patients were female [5].
The implant of a full or partial hip prosthesis or osteosynthesis by surgery constitutes the mainstay of treatment [6]. It is often performed within the first 24 to 72 h after HF. The timing of surgery is essential: the earlier the procedure is carried out, the lower the morbidity and mortality rates [7]. HF and the postoperative period are associated with several conditions, such as falls and new fractures, infections, pressure ulcers, delirium, cardiovascular events, and urinary tract infections (UTIs) [8]. Urinary catheterization is a routine procedure before surgery that is often withdrawn within 24 h [9]. Longer catheter use is associated with several urinary problems, including higher rates of UTI and postoperative urinary retention, and may result in hydronephrosis, pyelonephritis, renal insufficiency, bacteriuria, and urinary incontinence (UI) [9, 10].
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Despite the existing evidence regarding complications after hip fracture surgery (HFS), it is still unclear how the postoperative process contributes to developing UI or worsening previous UI, and few studies have prospectively assessed UI incidence after HFS [11]. Given the significant medical, economic, and social impact of this condition on older people [12], identifying modifiable risk factors for developing UI after HFS can aid in generating clinical protocols for its prevention. This prospective study aimed to assess the incidence of UI and the evolution of this condition among older patients undergoing HFS and investigate the risk factors associated with UI development and worsening in these patients.
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