• This study identified male sex, longer surgery duration, lumbosacral surgery and lower admission ADL score as independent risk factors for POUR after elective spine surgery. • We first reported admission Barthel Index (ADL) score as a novel predictive factor for postoperative urinary retention in spine surgery patients. • Random forest model (AUC=0.69) validated the predictive value of the identified risk factors for POUR, providing clinical guidance for risk stratification. This study aimed to evaluate the incidence of POUR in elective spine surgery patients and to identify the risk factors associated with its occurrence. Intermittent catheterization (IC) was utilized to address the POUR. We retrospectively analyzed the demographic and clinical data of patients who underwent elective posterior spinal surgery at our institution from January 1, 2017, to February 22, 2022. Collected data included surgery duration, surgical site, volume of intraoperative fluid, length of stay, activities of daily living (ADL), and demographic characteristics. Patients with indwelling catheters or those with complete preoperative urinary retention were excluded from the study. The independent risk factors for POUR were assessed using a multivariable logistic regression model. The efficiency of the indicated factors was assessed using a random forest (RF) classifier. A total of 345 patients who were enrolled in our study met the inclusion criteria. Of them, 31 patients (9.0%) developed POUR. Male sex (OR = 0.392; 95% CI: 0.167-0.921; P = 0.032), surgery duration (OR = 1.004; 95% CI: 1.001-1.007; P = 0.014), lower surgical site (OR = 3.551; 95% CI: 1.488-8.472; p = 0.004), and admission ADL score (OR = 0.964; 95% CI: 0.949-0.979; P < 0.001) were significantly correlated with an increased incidence of POUR. RF received an area under the curve of 0.69. Male sex, surgical duration, lower surgical site, and admission ADL score were independent risk factors for POUR and were effective in predicting the incidence of POUR. The identification of these risk factors may help better predict and manage voids postoperatively.
Xiao et al. (Wed,) studied this question.