Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost.

IF 2 3区 医学 Q2 UROLOGY & NEPHROLOGY
Camilo Arenas-Gallo, Mollie Goldman, Jack C Millot, Jacob McCann, Anyull D Bohorquez-Caballero, Stephen Rhodes, Vishu Chandrasekhar, Michael Callegari, Leo Puhalla, Adam Calaway, Randy Vince, Adithya Balasubramanian, Jim Hu, Bashir Al Hussein Al Awamlh, Spyridon P Basourakos, Lee Ponsky, Jonathan E Shoag
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引用次数: 0

Abstract

Objective: To describe national trends, predictors, insurance and patient costs associated with sedation use during prostate biopsies.

Methods: We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes. Biopsy type, anesthesia claims, comorbidities, and MRI use were determined through CPT/ICD-10 codes. Multivariable logistic regression assessed predictors of sedation use. Out-of-pocket costs were calculated by summing insurance copays, deductibles, and coinsurance, adjusted to 2021 dollars.

Results: The final cohort included 172,148 prostate biopsies. The mean patient age was 62 ± 8 years. The proportion of biopsies performed with sedation increased from 15.6% in 2016 to 25.5% in 2021. Saturation biopsies were nine times more likely to involve sedation than systematic biopsies (OR= 9.02, 98% CI= 8.18-9.95, p<0.001). Patients with a prior biopsy were 39% more likely to receive sedation (OR= 1.39, 98% CI= 1.35-1.43, p<0.001). MRI-guided biopsies were nearly twice as likely to involve sedation compared to non-MRI biopsies (OR= 1.98, 98% CI= 1.93-2.04, p<0.001). In 2021, the expected out-of-pocket cost for sedated biopsies was $663 USD (98% CI= $644-$682), compared to $489 USD (98% CI= $479-$498) for non-sedated procedures.

Conclusion: Sedation use during prostate biopsies is steadily increasing, alongside associated patient costs. Patients undergoing saturation biopsies, MRI-guided procedures, and those with prior biopsy history were more likely to receive sedation. These findings highlight evolving patterns in biopsy practices and underscore the need to balance patient comfort with procedural cost and accessibility considerations.

镇静在前列腺活检中的应用越来越多:国家趋势、预测因素和患者成本。
目的:描述全国趋势,预测因素,保险和患者费用与镇静使用期间前列腺活检。方法:我们使用Merative Marketscan数据库于2016年至2021年进行了一项回顾性队列研究。接受前列腺活检的男性使用CPT代码进行识别。通过CPT/ICD-10代码确定活检类型、麻醉要求、合并症和MRI使用情况。多变量logistic回归评估镇静使用的预测因素。自付费用是通过保险共付额、免赔额和共同保险的总和来计算的,调整为2021美元。结果:最终队列包括172148例前列腺活检。患者平均年龄62±8岁。镇静下进行活检的比例从2016年的15.6%上升到2021年的25.5%。饱和活检涉及镇静的可能性是系统活检的9倍(OR= 9.02, 98% CI= 8.18-9.95)。结论:前列腺活检中镇静的使用正在稳步增加,同时患者的费用也在增加。接受饱和活检、mri引导手术和有活检史的患者更有可能接受镇静治疗。这些发现突出了活检实践中不断变化的模式,并强调了平衡患者舒适度与手术成本和可及性考虑的必要性。
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来源期刊
Urology
Urology 医学-泌尿学与肾脏学
CiteScore
3.30
自引率
9.50%
发文量
716
审稿时长
59 days
期刊介绍: Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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