Objective To explore the mediating effect of postoperative kinesiophobia between frailty and occurrence risk of postoperative urinary retention in elderly patients with hip fracture. Methods A total of 246 elderly patients with hip fracture were selected as the research subjects by the random stratified sampling method. General data inventory, FRAIL scale, Tampa Scale for Kinesiophobia (TSK) were employed to perform inventory investigation on patients, and patients' preoperative blood examination indices were collected. The occurrence states of preoperative frailty, postoperative urinary retention, and kinesiophobia were analyzed. The influencing factors for patients suffering from postoperative urinary retention, and correlation of frailty level with postoperative kinesiophobia level were analyzed. The mediating effect of kinesiophobia between frailty and occurrence risk of postoperative urinary retention was evaluated by using the stepwise regression analysis method. Results (1) A total of 28 patients suffered from postoperative urinary retention, with the incidence rate of urinary retention in 11.4%. The total score of FRAIL scale among 246 patients was 0-5 (2.29±1.29). A total of 118 patients suffered from frailty, with the incidence rate of 48.0%. The total score of TSK among 246 patients was 25-62 (42.53±7.98). A total of 169 patients suffered from postoperative kinesiophobia, with the incidence rate of 68.7%. (2) Suffering from dementia, postoperative analgesic pump use, high FRAIL scale total score, high TSK total score were the independent risk factors for elderly patients with hip fracture suffering from postoperative urinary retention (P<0.05). The total score of FRAIL scale positively correlated with TSK total score in elderly patients with hip fracture (P<0.05). (3) The results of mediating effect analysis revealed that there was mediating effect of postoperative kinesiophobia between frailty and occurrence risk of postoperative urinary retention, and it was partial mediating effect. Conclusion The incidence rate of postoperative urinary retention is relatively high in elderly patients with hip fracture. Frailty level can directly affect the occurrence of postoperative urinary retention in patients, also can increase postoperative kinesiophobia level of patients, so as to indirectly affect the occurrence risk of urinary retention in patients after operation. In clinical work, it is suggested that preoperative frailty and postoperative kinesiophobia of elderly patients with hip fracture should be paid close attention to, and positive coping style should be conducted to reduce the occurrence of postoperative urinary retention.

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