PD24-09 ASSOCIATION BETWEEN OVERACTIVE BLADDER AND RISK OF FALLS AMONG MEDICARE ELDERLY FEE-FOR-SERVICE PATIENTS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2015PD24-09 ASSOCIATION BETWEEN OVERACTIVE BLADDER AND RISK OF FALLS AMONG MEDICARE ELDERLY FEE-FOR-SERVICE PATIENTS Ravishankar Jayadevappa, Sumedha Chhatre, Diane Newman, and Alan Wein Ravishankar JayadevappaRavishankar Jayadevappa More articles by this author , Sumedha ChhatreSumedha Chhatre More articles by this author , Diane NewmanDiane Newman More articles by this author , and Alan WeinAlan Wein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1464AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The burden of overactive bladder (OAB) and falls is often substantial for patients, families, employers, payers, and society. Objective: In this two part study, we sought to analyze the risk of falls associated with overactive bladder, and effects of treatment among fee-for-service Medicare beneficiaries METHODS We adopted a retrospective cohort design using 5% Medicare claims data between 2006 and 2009. Patients with a diagnosis of overactive bladder (ICD 9: 596.51), functional urinary incontinence (ICD 9: 788.91), urinary incontinence (ICD 9: 788.3), urinary frequency (ICD 9: 788.41), urgency urination (ICD 9: 788.63), Nocturia convert (ICD 9: 788.43), or stress urinary incontinence in women (ICD 9: 625.6) were identified, and were followed retrospectively for one-year pre and up to two years post diagnosis date. Logistic regression models were used to determine the association between OAB and falls (accidental falls, ICD 9: E880 - E888); and protective effect of treatment for OAB on risk of falls. Propensity scores and instrumental variables approach were used to minimize treatment bias. RESULTS We identified 32,587 patients (mean age=77.7 years, sd=7.6) with a diagnosis of OAB and. Of these, 57.3% were women and 82.8% were white. Medicare enrollees with a diagnosis of OAB had higher falls compared to those without an OAB diagnosis (10.2% vs. 5.3%, p<.001). Patients with OAB had higher comorbidity compared to non-OAB cohort. Overall, a diagnosis of OAB associated with higher odds of falls (Odds Ratio (OR)=1.40; 95% Confidence Interval (CI)=1.35, 1.46) compared to those without OAB diagnosis. Of all the persons with OAB, only 10% received treatment for OA, of these 77.3% are men. Treatment for overactive bladder was associated with lower odds of falls (OR=0.92; 95% CI= 0.87, 0.97) compared to OAB patients who did not receive treatment for OAB. CONCLUSIONS Elderly patients with OAB experience increased risk of falls. Treatment for OAB may reduce the risk of falls. These findings emphasize the need to effectively identify and treat OAB in elderly patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e489 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ravishankar Jayadevappa More articles by this author Sumedha Chhatre More articles by this author Diane Newman More articles by this author Alan Wein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...