Anastasiadis Eleni, van der Meulen Jan, Emberton Mark
Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK.
Int J Urol. 2015 Feb;22(2):181-6. doi: 10.1111/iju.12634. Epub 2014 Sep 26.
To investigate the complication rate within 30 days after transrectal ultrasound-guided biopsy of the prostate in England, and to examine associated risk factors.
A population-based study was carried out using the English cancer registry linked to administrative hospital data. We included men aged 45 years and older diagnosed with prostate cancer between 2000 and 2008. A complication was considered to have occurred if men had been admitted to hospital as a result of urological causes (urinary tract infection/sepsis, hematuria and urinary retention) within 30 days of the transrectal ultrasound-guided biopsy of the prostate. Multivariable logistic regression was carried out to estimate odds ratios, reflecting the impact of risk factors on the complication rate.
Of the 198,361 included men, 69% were aged between 65 and 84 years. The 30-day complication rate was 3.7% (1.1% for urinary tract infection/sepsis, 1.4% for hematuria and 1.3% for urinary retention). The most important risk factors were age above 85 years (odds ratio 3.85, 95% confidence interval 3.18-4.67, compared with age below 55 years) and three or more comorbidities (odds ratio 3.50, 95% confidence interval 3.17-5.87, compared with no comorbidity). The overall complication rate increased over time (odds ratio 1.20, 95% confidence interval 1.08-1.34, 2008 compared with 2000), as did the complication rate as a result of urinary tract infection/sepsis (odds ratio 1.72, 95% confidence interval 1.41-2.10, 2008 compared with 2000).
There has been an increase in the complication rate after transrectal ultrasound-guided biopsy of the prostate in England between 2000 and 2008, predominantly as a result of infections. Age and comorbid conditions seem to represent the two most important risk factors for occurrence of post-biopsy complications.
调查英格兰经直肠超声引导下前列腺穿刺活检术后30天内的并发症发生率，并探究相关危险因素。
利用与医院管理数据相链接的英国癌症登记系统开展一项基于人群的研究。我们纳入了2000年至2008年间确诊为前列腺癌的45岁及以上男性。如果男性在经直肠超声引导下前列腺穿刺活检术后30天内因泌尿系统原因（尿路感染/脓毒症、血尿和尿潴留）入院，则认为发生了并发症。采用多变量逻辑回归来估计比值比，以反映危险因素对并发症发生率的影响。
在纳入的198,3６1名男性中，69%年龄在65至84岁之间。30天并发症发生率为3.7%（尿路感染/脓毒症为1.1%，血尿为1.4%，尿潴留为1.3%）。最重要的危险因素是85岁以上（比值比3.85，95%置信区间3.18 - 4.67，与55岁以下相比）以及三种或更多合并症（比值比3.50，95%置信区间3.17 - 5.87，与无合并症相比）。总体并发症发生率随时间增加（比值比1.20，95%置信区间1.08 - 1.34，2008年与2000年相比），因尿路感染/脓毒症导致的并发症发生率也如此（比值比1.72，95%置信区间1.41 - 2.10，2008年与2000年相比）。
2000年至2008年间，英格兰经直肠超声引导下前列腺穿刺活检术后并发症发生率有所增加，主要原因是感染。年龄和合并症似乎是活检后并发症发生的两个最重要危险因素。
