2061 Is Repeat Prostate Biopsy Associated With a Greater Risk of Hospitalization? Data From Seer-Medicare

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122061 IS REPEAT PROSTATE BIOPSY ASSOCIATED WITH A GREATER RISK OF HOSPITALIZATION? DATA FROM SEER-MEDICARE Stacy Loeb, H. Ballentine Carter, Sonja Berndt, Winnie Ricker, and Edward Schaeffer Stacy LoebStacy Loeb NY, NY More articles by this author , H. Ballentine CarterH. Ballentine Carter Baltimore, MD More articles by this author , Sonja BerndtSonja Berndt Bethesda, MD More articles by this author , Winnie RickerWinnie Ricker Rockville, MD More articles by this author , and Edward SchaefferEdward Schaeffer Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2226AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Among Medicare participants, we recently reported an increasing risk of hospitalization following an initial prostate biopsy over time. Less is known about the relative risks of repeat prostate biopsies, which are frequently performed in prostate cancer screening and in active surveillance programs. Our goal was to determine whether repeat biopsies are associated with an increased risk of hospitalization compared to initial biopsy. METHODS Using Surveillance, Epidemiology and End Results (SEER)-linked Medicare data from 1991 to 2007, we identified 13,883 men who underwent a single prostate biopsy and 3640 with multiple biopsies. 30-day hospitalization rates were compared between these groups, and with a randomly selected control population (n=134,977). ICD-9 codes were then used to examine the frequency of serious infectious and non-infectious urological complications as the primary diagnosis for admissions. RESULTS Both initial and repeat biopsies were associated with a significantly increased risk of hospitalization within a 30 day period compared to randomly selected controls (Table). Compared to initial biopsy, repeat biopsy was associated with a significantly increased risk of hospitalization for serious infectious (OR 1.87, 95% CI 1.16-3.00, p=0.0098) and non-infectious urological complications (OR 1.78, 95% CI 1.04-2.96, p=0.04). Risk of overall hospitalization, serious infectious and serious non-infectious complications within 30 days for initial and repeat biopsies, compared to controls OR 95% CI p-value OVERALL HOSPITALIZATION Only 1 biopsy 3.06 2.85-3.29 <0.0001 Multiple biopsies 3.05 2.68-3.47 <0.0001 INFECTIOUS COMPLICATION Only 1 biopsy 2.41 1.81-3.22 <0.0001 Multiple biopsies 4.00 2.62-6.12 <0.0001 NON-INFECTIOUS UROLOGICAL COMPLICATION Only 1 biopsy 9.08 6.05-13.63 <0.0001 Multiple biopsies 15.66 8.91-27.50 <0.0001 CONCLUSIONS Repeat prostate biopsies are commonly performed in the diagnosis and management of prostate cancer, and may be associated with a greater risk of hospitalization for infectious and other urological complications compared to the initial biopsy procedure. Further exploration is needed to determine the underlying explanation for this increased risk and ways to improve the safety of prostate biopsy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e831-e832 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stacy Loeb NY, NY More articles by this author H. Ballentine Carter Baltimore, MD More articles by this author Sonja Berndt Bethesda, MD More articles by this author Winnie Ricker Rockville, MD More articles by this author Edward Schaeffer Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...