TY - JOUR
T1 - Association of Frailty and Complications Following Prostate Biopsy
T2 - Results From a Population-Based, Privately Insured Cohort
AU - Kiani, Kayvon
AU - Kim, Simon P.
AU - Pessoa, Rodrigo Rodrigues
AU - Gershman, Boris
AU - Gonzalez, Christopher
AU - Molina, Elizabeth
AU - Warren, Adam
AU - Dasilva, Rodrigo Donalisio
AU - Chapin, Brian
AU - Ballon-Landa, Eric
N1 - Publisher Copyright:
© 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Introduction:Prostate needle biopsy (PNBx) is essential for prostate cancer diagnosis, yet it is not without risks. We sought to assess patients who underwent PNBx using a claims-based frailty index to study the association between frailty and postbiopsy complications from a large population-based cohort. We hypothesized that increased frailty would be associated with adverse outcomes.Methods:Using Market Scan, we identified all men who underwent PNBx from 2010 to 2015. Individuals were stratified by claims-based frailty index into 2 prespecified categories: not frail, frail. Complications occurring within 30 days from prostate biopsy requiring emergency department, clinic, or hospital evaluations constituted the primary outcome. Unadjusted and adjusted analyses identified patient covariates associated with complications.Results:We identified 193,490 patients who underwent PNBx. The mean age was 57.6 years (SD: 5.0). In all, 5% were prefrail, mildly frail, or moderately to severely frail. The rate of overall complications increased from 11.1% for not frail to 15.5% for frail men. After adjusting for covariates, individuals with any degree of frailty experienced a higher risk of overall complication (odds ratio [OR]: 1.29; P <.001), clinic (OR: 1.26; P <.001) and emergency department visits (OR: 1.32; P =.02), and hospital readmissions (OR: 1.41; P <.001).Conclusions:Frailty was associated with a higher risk of complications for patients undergoing PNBx. Frailty assessment should be integrated into shared decision-making to limit the provision of potentially harmful care associated with prostate cancer screening.
AB - Introduction:Prostate needle biopsy (PNBx) is essential for prostate cancer diagnosis, yet it is not without risks. We sought to assess patients who underwent PNBx using a claims-based frailty index to study the association between frailty and postbiopsy complications from a large population-based cohort. We hypothesized that increased frailty would be associated with adverse outcomes.Methods:Using Market Scan, we identified all men who underwent PNBx from 2010 to 2015. Individuals were stratified by claims-based frailty index into 2 prespecified categories: not frail, frail. Complications occurring within 30 days from prostate biopsy requiring emergency department, clinic, or hospital evaluations constituted the primary outcome. Unadjusted and adjusted analyses identified patient covariates associated with complications.Results:We identified 193,490 patients who underwent PNBx. The mean age was 57.6 years (SD: 5.0). In all, 5% were prefrail, mildly frail, or moderately to severely frail. The rate of overall complications increased from 11.1% for not frail to 15.5% for frail men. After adjusting for covariates, individuals with any degree of frailty experienced a higher risk of overall complication (odds ratio [OR]: 1.29; P <.001), clinic (OR: 1.26; P <.001) and emergency department visits (OR: 1.32; P =.02), and hospital readmissions (OR: 1.41; P <.001).Conclusions:Frailty was associated with a higher risk of complications for patients undergoing PNBx. Frailty assessment should be integrated into shared decision-making to limit the provision of potentially harmful care associated with prostate cancer screening.
KW - frailty
KW - geriatric urology
KW - prostate cancer screening
KW - risk assessment
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U2 - 10.1097/UPJ.0000000000000476
DO - 10.1097/UPJ.0000000000000476
M3 - Article
C2 - 37914379
AN - SCOPUS:85181554224
SN - 2352-0779
VL - 11
SP - 117
EP - 122
JO - Urology Practice
JF - Urology Practice
IS - 1
ER -