Risk Factors for Infection after Prostate Biopsy in the United States
Jonathan E Shoag1, Christopher Gaffney1, Morgan Pantuck1
1Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY.
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.
Insights
Postbiopsy infection rates have stabilized, but emergency room, hospital, and intensive care unit admissions are increasing. Higher surgeon volume is linked to reduced infection risk and hospitalization.
Area of Science:
- Urology
- Healthcare Research
- Infectious Disease
Background:
- Postbiopsy infections pose a significant risk to patient health.
- Understanding trends in postbiopsy complications is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze trends in 30-day postbiopsy infection rates and associated healthcare utilization.
- To investigate the impact of surgeon volume and other factors on postbiopsy infection risk.
Main Methods:
- Utilized SEER-Medicare linked data from 2001-2015.
- Performed adjusted analyses on infection rates, emergency department, hospital, and ICU admissions.
- Examined effects of age, demographics, surgeon volume, rectal swab use, and biopsy year.
Main Results:
- Overall postbiopsy infection rates stabilized after 2007.
- Emergency room visits, hospitalizations, and ICU admissions postbiopsy significantly increased from 2001 to 2015.
- Surgeons performing ≥25 biopsies/year had lower odds of infection (OR 0.65) and hospitalization (OR 0.50) compared to those performing one biopsy/year.
Conclusions:
- Despite stabilized infection rates, increased healthcare utilization postbiopsy warrants attention.
- Higher surgeon volume is associated with decreased postbiopsy infection risk and hospitalization.
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