Can a Simple Geriatric Assessment Predict the Outcome of TURP?

Autor:	Eredics K; Department of Urology, Donauspital, Vienna, Austria, klaus.eredics@gmail.com., Meyer C; Department of Urology, Kaiser Franz Josef Hospital, Vienna, Austria., Gschliesser T; Department of Urology, Klinikum Klagenfurt, Vienna, Austria., Lodeta B; Department of Urology, Klinikum Klagenfurt, Vienna, Austria., Heissler O; Department of Urology, Landesklinikum Baden-Mödling, Vienna, Austria., Kunit T; Department of Urology, Paracelsus Medical University Salzburg, Vienna, Austria., Madersbacher S; Department of Urology, Kaiser Franz Josef Hospital, Vienna, Austria.; Department of Urology, Sigmund Freud Private University, Vienna, Austria.
Jazyk:	angličtina
Zdroj:	Urologia internationalis [Urol Int] 2020; Vol. 104 (5-6), pp. 367-372. Date of Electronic Publication: 2020 Apr 01.
DOI:	10.1159/000506717
Abstrakt:	Purpose: To determine the impact of a simple preoperative geriatric assessment on the outcome in older patients with recurrent urinary retention who underwent desobstructive surgery. Patients and Methods: Patients aged 75 years or older with recurrent urinary retention referred for TURP entered this prospective, multicentre study. Several demographic, intra- and postoperative parameters were assessed. Preoperative geriatric assessment was performed by the 7-item Canadian Study of Health and Ageing (CSHA) frailty scale (1: very fit, 7: severely frail; completion takes less than a minute). The main outcome parameters were successful voiding rates at discharge and 3 months postoperatively. Results: A total of 54 patients were recruited; 42 (77.8%) patients had a CSHA index of 1-3 and were considered as "fit", the remaining 12 (22.2%) formed the "frail" group (CSHA index 4-7). Age was identical in both cohorts (79.5 ± 3.7 vs. 79.7 ± 3.3 years); differences were demonstrable for the American Society of Anesthesiologists (ASA) score (p = 0.001), the number of daily medications (>4: 32 vs. 75%, p = 0.02), falls within the past 6 months (12 vs. 33%), and the necessity of home/nursing care (5 vs. 42%, p = 0.004). Intra- and perioperative complications, duration of postoperative catheterization, and length of hospitalization were identical in both cohorts. The success rate at discharge was 80.6% in fit and 75.0% in frail patients; the respective values at 3 months were 95.2 and 83.3%. Conclusions: A simple 1-min geriatric assessment tool can predict - to a certain extent - the outcome of desobstructive surgery in older patients with recurrent urinary retention. Fit patients achieve an excellent outcome while frail patients might benefit from a more in-depth urodynamic/geriatric evaluation. (© 2020 S. Karger AG, Basel.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu