Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois.
Public Health Sciences, Stritch School of Medicine, Loyola University Medical Center, Chicago, Illinois.
J Urol. 2020 Aug;204(2):332-336. doi: 10.1097/JU.0000000000000787. Epub 2020 Jan 28.
This retrospective cohort study evaluates the characteristics of patients who presented to the emergency department with acute urinary retention.
Using the Healthcare Cost and Utilization Project State Emergency Department Databases we conducted a retrospective cohort study of patients who presented to emergency departments in Florida between 2005 and 2015. Male patients age 45 years or older who presented with diagnosis codes for acute urinary retention and lower urinary tract symptoms/benign prostatic hyperplasia were considered. Information was collected on age, race/ethnicity, primary insurance and rural-urban commuting area codes.
The mean age for males presenting with acute urinary retention was 72.2 years, which was 10.6 years older than those presenting for nonurological complaints (p <0.001). Multivariable analysis adjusted for measured confounders found all covariates to be significant. The risk of presenting to the emergency department for acute urinary retention from lower urinary tract symptoms/benign prostatic hyperplasia increased with age, with the 75 to less than 85-year-old age group at the highest risk (OR 15.96, p <0.001). Other factors associated acute urinary retention 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 rural-urban commuting area codes (OR 1.31, p <0.001).
Male patients who presented to the emergency department for acute urinary retention with benign prostatic hyperplasia were more likely to be older, of nonwhite race, have Medicare or private insurance, and live in more urban areas. These data suggest that African American and Hispanic patients may be untreated or under treated for benign prostatic hyperplasia in the outpatient setting, resulting in an increased risk of presentation to the emergency department with acute urinary retention.
本回顾性队列研究评估了因急性尿潴留到急诊科就诊的患者的特征。
我们使用医疗保健成本和利用项目州急诊数据库，对 2005 年至 2015 年间佛罗里达州急诊科就诊的患者进行了回顾性队列研究。将年龄在 45 岁或以上、具有急性尿潴留和下尿路症状/良性前列腺增生诊断代码的男性患者纳入研究。收集的信息包括年龄、种族/民族、主要保险和城乡通勤区代码。
因急性尿潴留就诊的男性患者的平均年龄为 72.2 岁，比因非泌尿系统疾病就诊的患者大 10.6 岁（p<0.001）。经多变量分析调整了测量混杂因素后，所有协变量均有统计学意义。因下尿路症状/良性前列腺增生而出现急性尿潴留的急诊就诊风险随着年龄的增长而增加，75 岁至 85 岁以下年龄组的风险最高（OR 15.96，p<0.001）。与急性尿潴留相关的其他因素包括非裔美国人（OR 1.15，p<0.001）或西班牙裔（OR 1.75，p<0.001）种族、医疗保险（OR 1.27，p<0.001）或私人保险（OR 1.33，p<0.001），以及城乡通勤区代码（OR 1.31，p<0.001）。
因良性前列腺增生而出现急性尿潴留到急诊科就诊的男性患者更有可能年龄较大，非白人种族，有医疗保险或私人保险，居住在更城市化的地区。这些数据表明，非裔美国人和西班牙裔患者在门诊环境中可能未得到或未充分治疗良性前列腺增生，导致因急性尿潴留到急诊科就诊的风险增加。
