Thirty-day hospital revisits after prostate brachytherapy: who is at risk?

Autor: Li B; Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States., Kirshenbaum EJ; Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States., Blackwell RH; Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States., Gange WS; Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, United States., Saluk J; Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, United States., Zapf MAC; Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, United States., Kothari AN; Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, United States., Flanigan RC; Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States., Gupta GN; Department of Urology, Loyola University Medical Center, Maywood, IL 60153, United States.; Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, United States.
Jazyk: angličtina
Zdroj: Prostate international [Prostate Int] 2019 Jun; Vol. 7 (2), pp. 68-72. Date of Electronic Publication: 2018 Mar 14.
DOI: 10.1016/j.prnil.2018.03.003
Abstrakt: Background: Transperineal prostate brachytherapy is a common outpatient procedure for the treatment of prostate cancer. Whereas long-term morbidity and toxicities are widely published, rates of short-term complications leading to hospital revisits have not been well described.
Materials and Methods: Patients who underwent brachytherapy for prostate cancer in an ambulatory setting were identified in the Healthcare Cost and Utilization Project State Ambulatory Surgery Database for California between 2007 and 2011. Emergency department (ED) visits and inpatient admissions within 30 days of treatment were determined from the California Healthcare Cost and Utilization Project State Emergency Department Database and State Inpatient Database, respectively.
Results: Between 2007 and 2011, 9,042 patients underwent brachytherapy for prostate cancer. Within 30 days postoperatively, 543 (6.0%) patients experienced 674 hospital encounters. ED visits comprised most encounters (68.7%) at a median of 7 days (interquartile range 2-16) after surgery. Inpatient hospitalizations occurred on 155 of 674 visits (23.0%) at a median of 12 days (interquartile range 5-20). Common presenting diagnoses included urinary retention, malfunctioning catheter, hematuria, and urinary tract infection. Logistic regression demonstrated advanced age {65-75 years: odds ratio [OR], 1.3 [95% confidence interval (CI) 1.06-1.60, P  = 0.01]; >75 years: OR 1.5 [95% CI 1.18-1.97, P  = 0.001]}, inpatient admission within 90 days before surgery [OR 2.68 (95% CI 1.8-4.0, P  < 0.001)], and ED visit within 180 days before surgery [OR 1.63 (95% CI 1.4-1.89, P  < 0.001)] as factors that increased the risk of hospital-based evaluation after outpatient brachytherapy. Charlson comorbidity score did not influence risk.
Conclusions: ED visits and inpatient admissions are not uncommon after prostate brachytherapy. Risk of revisit is higher in elderly patients and those who have had recent inpatient or ED encounters.
Databáze: MEDLINE
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