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Systemic Comorbidity Burden Using the ACTIONS Phenotype Predicts Urologic Medication Discontinuation Following Transurethral Resection of the Prostate
- Source :
- Urology. 127:91-96
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- To assess the impact of systemic comorbidities on a validated health phenotype score (ACTIONS: Anxiety, Cardiovascular, Testosterone, Insulin/diabetes, Obesity, Neurologic, Sleep apnea) on outcomes of transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH) for symptoms and medication discontinuation.Comorbidities of men undergoing TURP for BPH from 2004 to 2015 were assessed with the validated ACTIONS phenotype totaling a score from 0 to 2 for each domain (Anxiety, Cardiovascular, Testosterone, Insulin/diabetes, Obesity, Neurologic, Sleep apnea). BPH medication discontinuation, change in International Prostate Symptom Score, postvoid residual, and patient satisfaction were assessed. Descriptive and comparative statistics were calculated with significance set at P.05.The 319 men had a median age of 74.0 (interquartile range 67-78). Mean ACTIONS score was significantly lower in men who discontinued alpha-blockers or 5-alpha reductase inhibitors compared to those who did not (3.37 ± 2.14vs 4.79 ± 2.75, P.0001). ACTIONS score4 was significantly associated with medication discontinuation (P = .0014). Lower scores in Testosterone (P = .04), Neurologic (P = .003), and Sleep apnea (P = .04) domains were significantly associated with medication discontinuation. Total ACTIONS score was not independently associated with changes in International Prostate Symptom Score or postvoid residual.Lower ACTIONS score was associated with BPH medication discontinuation after TURP, suggesting men with lower comorbidity burdens do better after the procedure. The ACTIONS phenotype score is easily calculated and may aid the preoperative counseling of men undergoing TURP for BPH.
- Subjects :
- Male
medicine.medical_specialty
Urology
medicine.medical_treatment
Prostatic Hyperplasia
030232 urology & nephrology
Comorbidity
urologic and male genital diseases
Risk Assessment
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Lower Urinary Tract Symptoms
Predictive Value of Tests
Prostate
Interquartile range
Diabetes mellitus
Internal medicine
Preoperative Care
medicine
Humans
Adrenergic alpha-Antagonists
Aged
Retrospective Studies
Transurethral resection of the prostate
business.industry
Incidence
Transurethral Resection of Prostate
Sleep apnea
Middle Aged
medicine.disease
Phenotype
Treatment Outcome
medicine.anatomical_structure
Withholding Treatment
030220 oncology & carcinogenesis
Urological Agents
Anxiety
International Prostate Symptom Score
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00904295
- Volume :
- 127
- Database :
- OpenAIRE
- Journal :
- Urology
- Accession number :
- edsair.doi.dedup.....85ead1eeadfb051982bb0a5871756394