Introduction

Transrectal prostate brachytherapy is a common outpatient procedure for the treatment of clinically-localized prostate cancer. While the long-term morbidity and toxicities of prostate brachytherapy are widely published, rates of short-term complications are largely unknown. We aim to determine the incidence of acute hospital visits for treatment-related complications of outpatient prostate brachytherapy and to identify associated risk favors.

Methods

Patients who underwent prostate brachytherapy (CPT code 55875) for prostate cancer (ICD9 code 185) in an ambulatory surgery setting were identified in the Healthcare Cost and Utilization Project (HCUP) State Ambulatory Surgery Database for California between 2007-2011. Emergency department visits and inpatient admissions within 30 days of treatment were determined from the California HCUP State Emergency Department Database and State Inpatient Database, respectively. Risk factor analysis was performed using multivariate logistic regression.

Results

Over five years, 8,188 patients underwent brachytherapy for prostate cancer. Within thirty days, 576 (7.0%) patients experienced 686 hospital visits. Emergency department visits comprised the majority of the encounters (623 visits (79.8%), at a median time from surgery of 5 days (IQR 1-13). Inpatient hospitalizations occured on 158 visits (20.2%) at a median 11 (IQR 5-20) days from surgery. Common presenting diagnoses included urinary retention n=335 (42.9%), hematuria n=59 (7.6%), and urinary tract infection n=47 (6.0%)._x000D_ Logistic regression demonstrated that increasing patient age (65-75 years: OR 1.3 (95% CI 1.1-1.6); >75 years: OR 1.6 (95% CI 1.3-2.1)) and any inpatient admission within 90 days prior to surgery (OR 1.6 (95% CI 1.3-1.9) increased the risk of requiring hospital-based medical evaluation following outpatient brachytherapy. Baseline medical comorbidity (Charlson score) did not influence risk.

Conclusions

Emergency department visits and inpatient admissions are common following prostate brachytherapy, though at less frequent rates than previously reported. Risk of readmission is higher in elderly patients and those who have had recent inpatient hospitalizations.

Funding

None