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Health Services Research & Development

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HSR&D Citation Abstract

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Patel PM, Sweigert SE, Nelson M, Gupta G, Baker M, Weaver FM, McVary KT. Disparities in BPH Progression: Predictors of Presentation to the Emergency Department in Urinary Retention. The Journal of urology. 2020 Jan 28; 101097JU0000000000000787.
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Abstract: PURPOSE: This retrospective cohort study evaluates the characteristics of patients who presented to the emergency department (ED) with acute urinary retention (AUR). MATERIALS AND METHODS: Using the Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD), we conducted a retrospective cohort study of patients who presented to EDs in Florida between 2005 and 2015. Male patients above 45 years of age who presented with diagnosis codes for both AUR and LUTS/BPH were considered. Information was collected on age, race/ethnicity, primary insurance, and rural-urban commuting area (RUCA) codes. RESULTS: The mean age for males presenting with AUR was 72.2 years, 10.6 years older than those presenting for non-urologic complaints (p < 0.001). Multivariable analysis adjusted for measured confounders found all covariates to be significant. The risk of presenting to the ED for AUR from LUTS/BPH increased with age, with the 75-85 year age-group at the highest risk (OR 15.96, p < 0.001). Other factors associated AUR 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 RUCA codes (OR 1.31, p < 0.001). CONCLUSIONS: Male patients who presented to the ED for AUR with BPH were more likely to be older, of non-white 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 undertreated for BPH in the outpatient setting, resulting in an increased risk of presentation to the ED with AUR.

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