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UPJ INSIGHT National Trends of Inpatient Radiation Cystitis: 2016-2019
By: Emily L. Neckonoff, BA, Columbia University Irving Medical Center, New York, New York; Joseph Marte, BS, Columbia University Irving Medical Center, New York, New York City University of New York School of Medicine, New York; Prakash Gorroochurn, PhD, Columbia University Irving Medical Center, New York, New York; Gregory A. Joice, MD, Columbia University Irving Medical Center, New York, New York; Christopher B. Anderson, MD, MPH, Columbia University Irving Medical Center, New York, New York | Posted on: 17 Jul 2024
Neckonoff EL, Marte J, Gorroochurn P, Joice GA, Anderson CB. National trends of inpatient radiation cystitis: 2016-2019. Urol Pract. 2024;11(4):700-707. doi:10.1097/UPJ.0000000000000579
Study Need and Importance
Radiation cystitis with hematuria (RCH) is a serious condition that most, if not all, urologists are tasked with treating over the course of their careers. Using the National Inpatient Sample (NIS) from 2016 to 2019, we sought to identify the trends in RCH admissions, as well as assessing possible risk factors for mortality, greater length of stay (LOS), and higher cost.
What We Found
From 2016 to 2019, 21,320 patients with either a primary or secondary diagnosis of RCH were recorded in the NIS. The majority of patients were older White men with a history of prostate cancer and an Elixhauser Comorbidity Score ≥ 3. Over the study period, we observed a 17% increase in the number of RCH inpatient encounters (Figure). Older age was found to be a significant predictor of inpatient mortality and greater LOS. Elixhauser Comorbidity Score ≥ 3 was found to be significantly associated with greater LOS and higher cost. Greater LOS was significantly associated with urban nonteaching and rural hospitals. Other significant predictors associated with higher costs were female sex, patients undergoing a procedure, private insurance, hospitals in the West, and greater median household income based on zip code.
Limitations
The NIS is dependent on proper coding to capture all events of the patient’s admission. If codes were not properly utilized, there may be an underestimation of the burden RCH patients presented. Additionally, since the NIS is fully anonymized, there is no recourse for identifying patients with multiple admissions over the study period.
Interpretation for Patient Care
RCH continues to be a concern for urologists across the US. With inpatient admissions increasing from 2016 to 2019, it is important for physicians to understand which patient populations could be at risk for the condition itself as well as for worse outcomes.
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