Hospitalization after transrectal biopsy of the prostate: A nationwide population-based inpatient versus outpatient comparison in Taiwan

Abstract

Purpose: The complications and hospitalization after transrectal biopsy of the prostate are increasingly concerned by patients and urologists. It remained unclear whether the incidence of complication after prostate biopsy at an inpatient basis is less than at an outpatient basis. The aim of the study is to compare complication rate the following inpatient versus outpatient prostate biopsy in Taiwan by analyzing the database of Bureau of National Health Insurance. Materials and Methods: Both outpatient and inpatient information were retrieved from the database maintained in the Bureau of National Health Insurance inTaiwan. The claimeddatasets between1996and2008basedon systemic sampling of 1,000,000 registered subjects at 2005 were searched for patients with prostate biopsy by using series connection of benign prostatic hyperplasia or prostate cancer patients with the prostate biopsy procedure. The hospitalization rate and visiting rate of emergency room (ER) were recorded and compared between inpatient and outpatient bases. Results: A total of 1155 inpatient and 308 outpatient patients received transrectal prostate biopsy. The age distribution did not differ (p1⁄4 0.478, chi-square test). The number of hospitalization between the inpatient and outpatient patients are 16 (1.36%) and 10 (3.25%), respectively (p1⁄4 0.027, chi-square test). The number of ER re-visit between the inpatient and outpatient patients are 36(3.11%) and 11 (3.51 %), respectively (p1⁄4 0.688, chi-square test). The reasons for hospitalization and ER re-visit of inpatient and outpatient patients are bleeding (11[0.95%] versus 3[0.97%], p1⁄4 0.972), infection (35[3.03%] versus 16[5.19%], p1⁄4 0.066), and lower urinary tract symptoms (6 [0.52%] versus 2[0.65%], p 1⁄40.784). Conclusion: The overall hospitalization and ER revisit rate is less at an inpatient basis than at an outpatient basis. The main causes are infection. Further study about the cost-effectiveness and predisposing factors are worthy to explore.