Geriatric Assessment Can Predict Outcomes of Endoscopic Surgery for Benign Prostatic Hyperplasia in Elderly Patients
| Autor: | N. Collet, C.P. Launay, T. Culty, O. Beauchet, S. Lebdail, A. Cerruti, T. Pichon, E Brassart, D. Chautard, A.R. Azzouzi, Pierre Bigot, N. Hoarau |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Health Services for the Aged Urology Prostatic Hyperplasia 030232 urology & nephrology Endoscopic surgery urologic and male genital diseases Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests medicine Humans Prospective Studies Prospective cohort study Geriatric Assessment Aged Aged 80 and over medicine.diagnostic_test Urinary retention business.industry Mortality rate Transurethral Resection of Prostate Endoscopy Geriatric assessment Urinary Retention Hyperplasia medicine.disease Surgery Treatment Outcome ROC Curve 030220 oncology & carcinogenesis Predictive value of tests medicine.symptom business |
| Zdroj: | Journal of Endourology. 31:1195-1202 |
| ISSN: | 1557-900X 0892-7790 |
| DOI: | 10.1089/end.2017.0325 |
| Popis: | Ojectives: Surgical management of benign prostatic hyperplasia (BPH) in elderly patients is associated with higher morbidity and mortality rate. This raises the question of benefice and risk balance. We conducted a prospective observational study to evaluate the results of endoscopic surgery for BPH in elderly patients, according to geriatric assessment.We included prospectively 60 patients older than 75 years, with an indwelling catheter for acute or chronic retention, who were candidates to endoscopic surgery for BPH. Patients underwent the brief geriatric assessment (BGA) and the comprehensive geriatric assessment (CGA) to classify them into three groups: "vigorous," "vulnerable," and "sick." Success was defined by the bladder catheter withdrawal after surgery.After geriatric assessment, 33 patients were classified in the "vigorous" group (55%), 25 in the "vulnerable" group (42%), and 2 in the "sick" group (3%). The success rate immediately after surgery was 85% and 41% in the "vigorous patient" group and the "vulnerable and sick" patient group, respectively (p 0.05). The success rate at 3 months after surgery was 94% and 55% (p 0.05). The morbidity was higher for the "vulnerable and sick" group (44%) compared with the "vigorous" group (15%) (p 0.05). The BGA also allowed predicting a higher risk of failure in patients with a score ≥3 immediately after surgery (odds ratio 5.9, confidence interval [95% CI] 1.61, 29.9) and 3 months after surgery (odds ratio 6.9, 95% CI 1.31, 70.8).Geriatric assessment can predict the outcome of endoscopic surgery for BPH for patients in retention older than 75 years. "Vulnerable and sick" patients had a higher risk to keep their indwelling catheter after the surgery compared with "vigorous" patients. The complication rate is also higher. The BGA can although predict a poor result of surgery when its score is equal or above 3/6. |
| Databáze: | OpenAIRE |
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