PD29-07 DISPARITIES IN BPH PROGRESSION: PREDICTORS OF PRESENTATION TO THE EMERGENCY DEPARTMENT IN URINARY RETENTION

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (PD29)1 Apr 2020PD29-07 DISPARITIES IN BPH PROGRESSION: PREDICTORS OF PRESENTATION TO THE EMERGENCY DEPARTMENT IN URINARY RETENTION Parth M. Patel, Sarah E. Sweigert*, Marc Nelson, Gopal Gupta, Marshall Baker, Francois Modave, and Kevin T. McVary Parth M. PatelParth M. Patel More articles by this author , Sarah E. Sweigert*Sarah E. Sweigert* More articles by this author , Marc NelsonMarc Nelson More articles by this author , Gopal GuptaGopal Gupta More articles by this author , Marshall BakerMarshall Baker More articles by this author , Francois ModaveFrancois Modave More articles by this author , and Kevin T. McVaryKevin T. McVary More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000893.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (LUTS/BPH) is an age-related process that can progress to acute urinary retention (AUR). Currently, no studies have evaluated what groups of patients present to the ED with AUR, the regional distribution, or the socioeconomic and demographic factors therein. We utilized a population-level administrative dataset to retrospectively evaluate patients who presented to the emergency room with AUR secondary to BPH. METHODS: Using the Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD), we conducted a retrospective cohort study of patients who presented to emergency departments in Florida between 2005 and 2015. Male patients above 45 years of age who presented with diagnosis codes for both AUR and LUTS/BPH were considered. Information was collected on age, race/ethnicity, primary insurance, and rural-urban commuting area (RUCA) codes. RESULTS: The mean age for patients presenting with AUR was 72.2 years, 10.6 years older than those presenting for non-urologic complaints (p < 0.001). A significantly higher proportion of AUR patients had Medicare insurance (68.9% versus 41.7%, p < 0.001). Greater proportions of the AUR patients belonged to urban RUCA codes (93.2% versus 91.3%, p < 0.001). On multivariable analysis adjusted for measured confounders, all covariates of interest demonstrated significance. The risk of presenting to the ED for AUR from LUTS/BPH increased with age, with the 75-85 year age-group at the highest risk (OR 15.96, p<0.001). Other factors associated with presentation to the ED with AUR included African-American (OR 1.15, p<0.001) or Hispanic (OR 1.75, p<0.001) race, Medicare (OR 1.27, p<0.001) or private (OR 1.33, p<0.001) insurance, and urban RUCA codes (OR 1.31, p<0.001). CONCLUSIONS: Male patients older than 45 who presented to the ED for AUR with BPH were more likely to be older, of non-white race, have Medicare or private insurance, and live in more urbanized areas. We surmise that African-American and Hispanic patients may be untreated or undertreated for BPH in the outpatient setting, resulting in an increased risk of presentation to the ED with AUR. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e620-e620 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Parth M. Patel More articles by this author Sarah E. Sweigert* More articles by this author Marc Nelson More articles by this author Gopal Gupta More articles by this author Marshall Baker More articles by this author Francois Modave More articles by this author Kevin T. McVary More articles by this author Expand All Advertisement PDF downloadLoading ...