Jonathan E Shoag1, Christopher Gaffney1, Morgan Pantuck1, Tianyi Sun2, Michael Gorin3, Edward Schaeffer4, Art Sedrakyan2, Andrew Vickers5, Jim Hu6. 1. Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY. 2. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY. 3. Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD. 4. Department of Urology, Northwestern University, Chicago, IL. 5. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. 6. Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY. Electronic address: jch9011@med.cornell.edu.
Abstract
METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 2001 to 2015 and recorded 30-day infection rates and emergency department, hospital and, intensive care unit (ICU) admissions. We performed adjusted analyses to analyze the effect of age, demographic data, surgeon volume, rectal swab use, and biopsy year on infections. RESULTS: We found that the overall rate of postbiopsy infections increased from 2001 (5.9%) to 2007 (7.2%) but remained stable through 2015. Despite this, postbiopsy emergency room visits rose from 0.2% to 0.5% (95% confidence interval [CI] 0.2%-0.4%, P < .01), hospitalizations rose from 0.5% to 1.3% (95% CI 0.5%-1.0%, P < .01), and ICU admissions increased from 0.1% to 0.3% (95% CI 0.1%-0.3%, P < .01). Patients of surgeons who performed 25 biopsies per year had lower odds of postbiopsy infection (odds ratio 0.65; 95% CI 0.61-0.69) and a lower risk of hospitalization (odds ratio 0.50; 95% CI 0.43-0.59) as compared to patients of surgeons who performed one biopsy per year. Rectal swab use increased over the study period but remained low (1.8% in 2015). CONCLUSION: While the overall rate of postbiopsy infections has stabilized since 2007, admissions to the emergency room, hospital, and ICU continue to rise. Increased surgeon volume was associated with a decreased risk of infection.
METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 2001 to 2015 and recorded 30-day infection rates and emergency department, hospital and, intensive care unit (ICU) admissions. We performed adjusted analyses to analyze the effect of age, demographic data, surgeon volume, rectal swab use, and biopsy year on infections. RESULTS: We found that the overall rate of postbiopsy infections increased from 2001 (5.9%) to 2007 (7.2%) but remained stable through 2015. Despite this, postbiopsy emergency room visits rose from 0.2% to 0.5% (95% confidence interval [CI] 0.2%-0.4%, P < .01), hospitalizations rose from 0.5% to 1.3% (95% CI 0.5%-1.0%, P < .01), and ICU admissions increased from 0.1% to 0.3% (95% CI 0.1%-0.3%, P < .01). Patients of surgeons who performed 25 biopsies per year had lower odds of postbiopsy infection (odds ratio 0.65; 95% CI 0.61-0.69) and a lower risk of hospitalization (odds ratio 0.50; 95% CI 0.43-0.59) as compared to patients of surgeons who performed one biopsy per year. Rectal swab use increased over the study period but remained low (1.8% in 2015). CONCLUSION: While the overall rate of postbiopsy infections has stabilized since 2007, admissions to the emergency room, hospital, and ICU continue to rise. Increased surgeon volume was associated with a decreased risk of infection.
Authors: Robert K Nam; Refik Saskin; Yuna Lee; Ying Liu; Calvin Law; Laurence H Klotz; D Andrew Loblaw; John Trachtenberg; Aleksandra Stanimirovic; Andrew E Simor; Arun Seth; David R Urbach; Steven A Narod Journal: J Urol Date: 2013-01 Impact factor: 7.450
Authors: Matthew J Roberts; Alastair Macdonald; Sachinka Ranasinghe; Harrison Bennett; Patrick E Teloken; Patrick Harris; David Paterson; Geoff Coughlin; Nigel Dunglison; Rachel Esler; Robert A Gardiner; Thomas Elliott; Louisa Gordon; John Yaxley Journal: Prostate Cancer Prostatic Dis Date: 2020-08-05 Impact factor: 5.554