MP35-19 BASELINE FUNCTIONAL STATUS PREDICTS POSTOPERATIVE TREATMENT FAILURE IN NURSING HOME RESIDENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2016MP35-19 BASELINE FUNCTIONAL STATUS PREDICTS POSTOPERATIVE TREATMENT FAILURE IN NURSING HOME RESIDENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) Anne M Suskind, Louise C Walter, Shoujun Zhao, and Emily Finlayson Anne M SuskindAnne M Suskind More articles by this author , Louise C WalterLouise C Walter More articles by this author , Shoujun ZhaoShoujun Zhao More articles by this author , and Emily FinlaysonEmily Finlayson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1611AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bladder outlet obstruction, a common problem in older men, is often treated by transurethral resection/incision of the prostate (TURP/TUIP) to avoid the need for an indwelling foley catheter. However, older men with functional impairment who reside in nursing homes may receive little benefit from this surgery. The objective of this study is to determine whether poor functional status is associated with TURP/TUIP failure, as measured by the presence of a foley catheter 1-year post surgery. METHODS Using inpatient Medicare claims and the Minimum Data Set (MDS) for Nursing Homes, we identified all male nursing home residents who underwent inpatient TURP/TUIP from 2005 to 2009. We examined changes in activities of daily living (ADL) up to 12 months post surgery and factors associated with operative failure. The primary outcome of interest was surgical failure, measured by the presence of an indwelling foley catheter 1 year after surgery. RESULTS We identified 2,869 men residing in nursing homes who underwent TURP/TUIP during the study period. Over half of the cohort (59%) had a foley catheter before the procedure. Among men who had a foley at baseline, 64% had a foley, 4% had no foley, and 32% had died 1-year post procedure (Figure). In regression analysis, the presence of a foley catheter at baseline (RR 1.37; p<0.01), ADL decline before the procedure (RR 1.10; p=0.02), worse baseline ADL score (RR 1.34; p<0.01), and hospitalizations in the year prior to surgery (RR 1.24; p<0.01) were associated with an increased risk of surgical failure among 1-year survivors. Older age and high Charlson comorbidity score were not associated with a significant increased risk of TURP/TUIP failure. CONCLUSIONS The majority of men who had a foley at baseline and were alive at 1 year follow up continued to have a foley catheter. Poor baseline physical function is associated with an increased risk of TURP/TUIP failure, as measured by the presence of a foley catheter 1-year post procedure. Preoperative measurement of ADLs may aid in surgical decision-making by identifying patients in whom TURP/TUIP is unlikely to be of benefit. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e488 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Anne M Suskind More articles by this author Louise C Walter More articles by this author Shoujun Zhao More articles by this author Emily Finlayson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...