According to a SEER based study using administrative claims-based data, hospitalization related to PNB complications has been reported as high as 6.9%. Other studies have reported lower 1.40% hospitalization rates.
The purpose of our study was examine the incidence and type of complications that occurred following 2,588 Prostate Needle Biopsies over a 30 month period in our Integrated Urology Group Practice, Genesis Healthcare Partners in San Diego.
We used a proprietary software platform, WizMD™ to automatically abstract/mine data from our Allscripts™ EMR (both PM and Clinical) as well as manual review of charts to ensure causality related to the biopsy. We defined a serious PNB related complication as an unintended but related hospital, Emergency Department (ED), Urgent Care (UC) or doctor’s office visit within 30 days. Causality was defined according to a direct relationship between biopsy and adverse outcome. The study included 2 components: an EMR data abstraction and a direct- to- patient questionnaire asking details of their biopsy and any related complications.
According to the EMR study, we identified 69 (2.67%) serious complications leading to either hospitalization, treatment at an Emergency Department (ED), Urgent Care (UC), or doctor’s office. Thirty patients experienced serious complications resulting in hospitalization (1.16%). In contrast, the questionnaire study revealed that 4.25% of patients experienced serious complications of whom 1.06% were hospitalized. We observed that more than 50% of serious complications did not result in hospitalization and were managed in the outpatient setting (ED, UC, and doctor’s office). Similar to another published study, we found no difference in infectious complications in men undergoing a repeat PNB compared to those undergoing their first biopsy.
Our findings in summary were:
- Slightly > 1 % of patients were hospitalized according to both studies
- 56% of patients were managed outside of the hospital
- 65 % of complications were infections
- Non Infectious Complications (35 %) included Urinary Retention, Severe/Persistent gross hematuria, Rectal Bleeding (requiring transfusion)
Franklin Gaylis MD, FACS, Chief Scientific Officer, Genesis Healthcare Partners, Voluntary Professor of Urology, University of California, San Diego
Paul Dato MD, Medical Director, Genesis Healthcare Partners
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