58 TOTAL ILLNESS BURDEN INDEX FOR PROSTATE CANCER (TIBI-CAP) PRIOR TO PROSTATE BIOPSY CAN PREDICT OTHER CAUSE MORBIDITY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes I1 Apr 201258 TOTAL ILLNESS BURDEN INDEX FOR PROSTATE CANCER (TIBI-CAP) PRIOR TO PROSTATE BIOPSY CAN PREDICT OTHER CAUSE MORBIDITY Michael Liss, Jane Cho, Kathryn Osann, Ross Moskowitz, Adam Kaplan, John Billimek, Sheldon Greenfield, and Atreya Dash Michael LissMichael Liss Irvine, CA More articles by this author , Jane ChoJane Cho Irvine, CA More articles by this author , Kathryn OsannKathryn Osann Irvine, CA More articles by this author , Ross MoskowitzRoss Moskowitz Irvine, CA More articles by this author , Adam KaplanAdam Kaplan Irvine, CA More articles by this author , John BillimekJohn Billimek Irvine, CA More articles by this author , Sheldon GreenfieldSheldon Greenfield Irvine, CA More articles by this author , and Atreya DashAtreya Dash Irvine, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.103AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The treatment of prostate cancer is evaluated in the context of a patient's age and comorbidity. Shifting the assessment of a patient's health status to a point earlier in the process of disease evaluation and treatment may be useful to identify more suitable candidates to begin this process earlier rather than later. The Total Illness Burden Index for Prostate Cancer (TIBI-CaP) questionnaire is an immediate patient reported measure of comorbidity to guide decision making. We compare it prospectively to the standard physician reported Charlson Comorbidity Index (CCI) in patients undergoing prostate biopsy to predict hospital admissions. METHODS A prospective observational cohort study was performed of 133 participants prior to obtaining a transrectal ultrasound guided prostate biopsy. Eleven patients had incomplete data or missing follow-up; therefore, a total of 122 (92%) patients were retained for a mean of 21 months (range 4 - 31 months). The TIBI-CaP and CCI scores were compared between subgroups defined by non-elective hospital admission, elective surgery, non-prostate malignancy and survival status using t-tests. RESULTS Patients averaged 64.5 years at enrollment. One patient died in the study from a metastatic squamous cell carcinoma. The overall hospital admission rate was 17% (21/122), most commonly from cardiovascular or pulmonary disease. Forty-six men (38%) were diagnosed with cancer on the prostate biopsy. Twenty-three percent (28/122) had elective non-prostate surgery and 5% (6/122) were diagnosed with a non-prostate malignancy. Mean TIBI-CaP scores were higher in men who were admitted to the hospital (5.1 vs. 3.5, p=0.03), had elective surgery (4.8 vs. 3.4, p=0.05) or non-prostate cancers (5.5 vs 3.7, p=0.17) with odds ratios displayed in figure 1. No significant differences were observed in CCI scores. In stepwise logistic regression, a TIBI-CaP score > 5.0 was associated with 3.5 times higher risk for hospital admission (95% CI: 1.3-10.0, p=0.02). CONCLUSIONS The patient-reported measure of comorbidity (TIBI-CaP) identified patients at high risk for non-elective hospital admission over at 20 month average follow up period and may aid medical decision making specifically in the prostate biopsy population better than that of the Charlson Comorbidity Index. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e25 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Liss Irvine, CA More articles by this author Jane Cho Irvine, CA More articles by this author Kathryn Osann Irvine, CA More articles by this author Ross Moskowitz Irvine, CA More articles by this author Adam Kaplan Irvine, CA More articles by this author John Billimek Irvine, CA More articles by this author Sheldon Greenfield Irvine, CA More articles by this author Atreya Dash Irvine, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...