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- Title
Functional Outcomes After Transurethral Resection of the Prostate in Nursing Home Residents.
- Authors
Suskind, Anne M.; Walter, Louise C.; Zhao, Shoujun; Finlayson, Emily
- Abstract
Objectives To understand outcomes of transurethral resection of the prostate ( TURP) or transurethral laser incision of the prostate ( TULIP) for the treatment of bladder outlet obstruction in men with high levels of functional dependence, which are poorly understood. Design Retrospective cohort study. Setting U.S. nursing homes ( NHs). Participants Male NH residents aged 65 and older who underwent TURP or TULIP in the United States between 2005 and 2008 (N = 2,869). Measurements Changes in activities of daily living ( ADLs), Foley catheter status, and survival up to 12 months after surgery were examined. Multivariate regression was used to determine risk of having a Foley catheter 1 year after surgery. Results Sixty-one percent of the cohort had a Foley catheter before the procedure. Of men with a Foley catheter at baseline, 64% had a Foley catheter, 4% had no Foley catheter, and 32% had died by 1-year after the procedure. Having a Foley catheter at baseline (risk ratio ( RR) = 1.39, 95% confidence interval ( CI) = 1.29-1.50) and poor baseline functional status ( RR = 1.34, 95% CI = 1.18-1.52 for individuals in the worst quartile of function) were associated with greater risk of having a Foley catheter at 1-year. Conclusion Poor baseline functional status and having a Foley catheter preoperatively were associated with greater risk of TURP or TULIP failure, as measured by the presence of a Foley catheter at 1 year. Preoperative measurement of ADLs may aid in surgical decision-making in this population.
- Subjects
UNITED States; FUNCTIONAL loss in older people; HEALTH outcome assessment; TRANSURETHRAL prostatectomy; MEDICAL care of nursing home patients; PROSTATE surgery; BLADDER obstruction; NURSING care facilities; URINARY catheters; PATIENTS; MEDICAL care; THERAPEUTICS; ACTIVITIES of daily living; GERIATRIC assessment; CONFIDENCE intervals; MEDICAL lasers; NURSING home patients; RISK assessment; URETERIC obstruction; DECISION making in clinical medicine; MULTIPLE regression analysis; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; ODDS ratio
- Publication
Journal of the American Geriatrics Society, 2017, Vol 65, Issue 4, p699
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.14665