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.
TY - JOUR
T1 - Functional Outcomes After Transurethral Resection of the Prostate in Nursing Home Residents.
AU - Suskind,Anne M,
AU - Walter,Louise C,
AU - Zhao,Shoujun,
AU - Finlayson,Emily,
Y1 - 2016/12/05/
PY - 2016/12/6/pubmed
PY - 2017/5/6/medline
PY - 2016/12/6/entrez
KW - Foley catheter
KW - Medicare
KW - frail
KW - geriatric
KW - urology
SP - 699
EP - 703
JF - Journal of the American Geriatrics Society
JO - J Am Geriatr Soc
VL - 65
IS - 4
N2 - 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.
SN - 1532-5415
UR - https://www.unboundmedicine.com/medline/citation/27918098/Functional_Outcomes_After_Transurethral_Resection_of_the_Prostate_in_Nursing_Home_Residents_
DB - PRIME
DP - Unbound Medicine
ER -
