Urinary Catheterization Management in Older Adults With Hip Fracture: A Systematic Review

Objectives: Urinary catheterization is a common procedure in the perioperative management of patients with hip fracture. However, decisions on its insertion or removal are often variable. This systematic review aimed to synthesize current evidence on urinary catheterization management in older patients with hip fracture by thoroughly reviewing the implementation of structured programs. Design: Systematic review. Setting and participants: Older adults hospitalized for hip fracture. Methods: Studies published until April 1, 2023, were retrieved from MEDLINE (PubMed interface), SCOPUS (Elsevier interface), and Cochrane Central Register of Controlled Trials (EBSCO interface). Observational and interventional studies investigating the use of urinary catheterization in older adults with hip fracture were included and corresponding data on structured programs and associated results were extracted. The quality assessment of the studies was performed using the Critical Appraisal Skills Programme tool. Results: Of the 674 articles identified through the literature search, 16 studies were included. The mean ages in the 16 studies ranged from 67 to 86 years. Studies on the implementation of structured programs were few and heterogeneous. These studies identified 24 to 48 hours as the appropriate duration of postoperative catheterization; intermittent catheterization was associated with a lower incidence of complications. Conclusions and implications: Our review revealed a lack of standardized perioperative urinary catheterization management in older patients with hip fracture and uncovered the need for a tailored approach, which is crucial to improving the quality of care and outcomes in these patients.