Risk of hospitalization and death following prostate biopsy in Scotland

TY - JOUR

T1 - Risk of hospitalization and death following prostate biopsy in Scotland

AU - Brewster, David H.

AU - Fischbacher, Colin M.

AU - Nolan, J.

AU - Nowell, S.

AU - Redpath, D.

AU - Nabi, Ghulam

N1 - This work was supported by the Chief Scientist Office of the Scottish Government (grant number CZH/4/1039).

PY - 2017/1

Y1 - 2017/1

N2 - Objective: To investigate the risk of hospitalization and death following prostate biopsy. Study design: Retrospective cohort study. Methods: Our study population comprised 10,285 patients with a record of first ever prostate biopsy between 2009 and 2013 on computerized acute hospital discharge or outpatient records covering Scotland. Using the general population as a comparison group, expected numbers of admissions/deaths were derived by applying age-, sex-, deprivation category-, and calendar year-specific rates of hospital admissions/deaths to the study population. Indirectly standardized hospital admission ratios (SHRs) and mortality ratios (SMRs) were calculated by dividing the observed numbers of admissions/deaths by expected numbers. Results: Compared with background rates, patients were more likely to be admitted to hospital within 30 days (SHR 2.7; 95% confidence interval 2.4, 2.9) and 120 days (SHR 4.0; 3.8, 4.1) of biopsy. Patients with prior co-morbidity had higher SHRs. The risk of death within 30 days of biopsy was not increased significantly (SMR 1.6; 0.9, 2.7), but within 120 days, the risk of death was significantly higher than expected (SMR 1.9; 1.5, 2.4). The risk of death increased with age and tended to be higher among patients with prior co-morbidity. Overall risks of hospitalization and of death up to 120 days were increased both in men diagnosed and those not diagnosed with prostate cancer. Conclusions: Higher rates of adverse events in older patients and patients with prior co-morbidity emphasizes the need for careful patient selection for prostate biopsy and justifies ongoing efforts to minimize the risk of complications.

AB - Objective: To investigate the risk of hospitalization and death following prostate biopsy. Study design: Retrospective cohort study. Methods: Our study population comprised 10,285 patients with a record of first ever prostate biopsy between 2009 and 2013 on computerized acute hospital discharge or outpatient records covering Scotland. Using the general population as a comparison group, expected numbers of admissions/deaths were derived by applying age-, sex-, deprivation category-, and calendar year-specific rates of hospital admissions/deaths to the study population. Indirectly standardized hospital admission ratios (SHRs) and mortality ratios (SMRs) were calculated by dividing the observed numbers of admissions/deaths by expected numbers. Results: Compared with background rates, patients were more likely to be admitted to hospital within 30 days (SHR 2.7; 95% confidence interval 2.4, 2.9) and 120 days (SHR 4.0; 3.8, 4.1) of biopsy. Patients with prior co-morbidity had higher SHRs. The risk of death within 30 days of biopsy was not increased significantly (SMR 1.6; 0.9, 2.7), but within 120 days, the risk of death was significantly higher than expected (SMR 1.9; 1.5, 2.4). The risk of death increased with age and tended to be higher among patients with prior co-morbidity. Overall risks of hospitalization and of death up to 120 days were increased both in men diagnosed and those not diagnosed with prostate cancer. Conclusions: Higher rates of adverse events in older patients and patients with prior co-morbidity emphasizes the need for careful patient selection for prostate biopsy and justifies ongoing efforts to minimize the risk of complications.

KW - Biopsy

KW - Complications

KW - Hospitalization

KW - Morbidity

KW - Mortality

KW - Prostrate

U2 - 10.1016/j.puhe.2016.10.006

DO - 10.1016/j.puhe.2016.10.006

M3 - Article

C2 - 27810089

SN - 0033-3506

VL - 142

SP - 102

EP - 110

JO - Public Health

JF - Public Health

ER -