5α-還原酶抑製劑和經尿道前列腺切除術後出血事件 - 台灣健保資料庫研究
楊迪媛1,2、陳建志1,3、林文榮1,2、李中一4,5、蔡維恭1,2、邱文祥1,2,6,、柯明中7,8
1馬偕紀念醫院泌尿科, 2馬偕醫學院, 3馬偕醫護管理專科學, 4國立成功大學公共衛生研究所,
5中國醫藥大學, 6國立陽明大學醫學, 7臺北市立聯合醫院泌尿科, 8國立臺北護理健康大學
5α-reductase inhibitors and hemorrhagic events required intervention after TURP
– a nationwide study
Ti-Yuan Yang1,2, Marcelo Chen 1,3, Wun-Rong Lin 1,2, Chung-Yi Li 4,5, Wei-Kung Tsai 1,2,
Allen W. Chiu 1,2,6, Ming-Chung Ko 7,8
1 Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan
2 Department of Medicine, Mackay Medical College, Taipei, Taiwan
3 Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
4 Department of Public Health College of Medicine, National Cheng Kung University, Tainan, Taiwan
5 Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
6 School of Medicine, National Yang-Ming University, Taipei, Taiwan
7 Department of Urology, Taipei City Hospital, Taipei, Taiwan
8 Department of Health Care Management, National Taipei University of Nursing and Health Sciences. Taipei, Taiwan
Purpose:
To assess the association between preoperative treatment with 5ARIs and the subsequent risk of blood transfusion, blood clot evacuation and emergency department visits for hematuria within 1 month after transurethral resection of the prostate (TURP).
Materials and Methods:
We used data from the Taiwan National Health Insurance Research Database (NHIRD) in this population-based study. A total of 3,126 patients undergoing a first TURP for benign prostatic hyperplasia from 2004 to 2013 were identified. Adjusted odds ratios (AORs) estimated from a multiple logistic regression model were used to assess the independent effect of preoperative treatment with 5ARIs on the risk of perioperative hemorrhagic events after adjusting for potential confounders.
Results:
Two hundred and ninety-seven (9.4%) patients received 5ARIs for <3 months and 65 (2.1%) patients for ≥3 months. The blood transfusion rates for the patients who did not receive 5ARIs (controls), and those who received 5ARIs for <3 months and for ≥3 months were 9.5%, 8.8%, and 3.1%, respectively. Compared to the controls, patients who received 5ARIs for ≥3 months had a lower risk of blood transfusion (AOR=0.14, 95% confidence interval: 0.02-1.01). Aged ≥80 years, coagulopathy and weight of resected prostate tissue >50 g were associated with significantly higher risk of blood transfusion.
Conclusion:
Preoperative treatment with 5ARIs for ≥3 months tended to reduce the risk of blood transfusion related to TURP. However, there was no significant association between preoperative treatment with 5ARIs and the risk of blood clot evacuation and emergency department visits with hematuria within 1 month after TURP.