Blaschko Sarah D, Gaither Thomas W, Alwaal Amjad, Harris Catherine R, McCulloch Charles E, McAninch Jack W, Breyer Benjamin N
Department of Urology, University of California, San Francisco, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
Urol Pract. 2015 Nov;2(6):329-334. doi: 10.1016/j.urpr.2015.02.006. Epub 2015 Sep 2.
We characterize comorbidities and inpatient complications of patients with lichen sclerosus who underwent urethroplasty from a large national patient data source.
We queried the Nationwide Inpatient Sample for patients who underwent urethroplasty between 2000 and 2010. We compared demographics, comorbidities, complications, length of hospital stay and hospital charges for patients with and without the diagnosis of lichen sclerosus.
An estimated 13,700 urethroplasties were performed in the United States during the study period. Patients with lichen sclerosus comprised an estimated 3.8% of the urethroplasty population. The majority of patients with urethral stricture with lichen sclerosus were Caucasian (84%) and older, with 63% age 45 or older. Chronic hypertension, diabetes mellitus, rheumatoid arthritis/collagen vascular disease and obesity were associated with increased odds of having a lichen sclerosus diagnosis. The central East Coast (7.2%) and the Pacific Northwest (6.3%) had the highest percentage of patients treated with urethroplasty with lichen sclerosus. Patients with lichen sclerosus had longer hospital stays than those without lichen sclerosus (3.5 vs 2.6 days, p <0.0001). Patients with lichen sclerosus had more complications and hospital charges than those without lichen sclerosus but these differences did not reach statistical significance.
A higher percentage of patients with lichen sclerosus had comorbidities, increased complications and longer hospital stays compared to patients treated with urethroplasty without lichen sclerosus. Our findings demonstrate the increased complexity that providers face when treating men with lichen sclerosus related urethral stricture disease.
我们从一个大型全国患者数据源中,对接受尿道成形术的硬化性苔藓患者的合并症和住院并发症进行了特征分析。
我们查询了全国住院患者样本中2000年至2010年间接受尿道成形术的患者。我们比较了有和没有硬化性苔藓诊断的患者的人口统计学、合并症、并发症、住院时间和住院费用。
在研究期间,美国估计进行了13700例尿道成形术。硬化性苔藓患者约占尿道成形术患者总数的3.8%。大多数患有硬化性苔藓的尿道狭窄患者为白种人(84%)且年龄较大,63%的患者年龄在45岁及以上。慢性高血压、糖尿病、类风湿关节炎/胶原血管病和肥胖与硬化性苔藓诊断几率增加相关。东海岸中部(7.2%)和太平洋西北部(6.3%)接受尿道成形术治疗的硬化性苔藓患者比例最高。患有硬化性苔藓的患者住院时间比没有硬化性苔藓的患者更长(3.5天对2.6天,p<0.0001)。患有硬化性苔藓的患者比没有硬化性苔藓的患者有更多并发症和更高的住院费用,但这些差异未达到统计学显著性。
与未患硬化性苔藓而接受尿道成形术的患者相比,患硬化性苔藓的患者合并症更多、并发症增加且住院时间更长。我们的研究结果表明,医疗服务提供者在治疗患有与硬化性苔藓相关的尿道狭窄疾病的男性患者时面临的复杂性增加。