Login to Access Video or Poster Abstract: MP11-16
Sources of Funding: None.

Introduction

Uptake of active surveillance and changes in prostate cancer care may affect utilization of and complications following prostate needle biopsy (PNBx). We characterized recent trends and risk factors for PNBx complications using a statewide, all-payer cohort.

Methods

We utilized the New York Statewide Planning and Research Cooperation System (SPARCS) to identify PNBx performed between 2011 and 2014 via transrectal (N=9472) and transperineal (N=421) approach. We characterized trends in utilization and complications using Poisson regression and Cochrane-Armitage tests. We used logistic regression to examine predictors of complications within 30 days of PNBx.

Results

Ambulatory utilization of PNBx decreased over time (p<0.01). The most common indication for PNBx was elevated PSA (53.2%), followed by active surveillance for cancer (26.7%), abnormal DRE (2.6%) and atypia (1.6%). _x000D_ _x000D_ _x000D_ PNBx-associated infection rates increased from 2.6% to 3.5% during the study period (p=0.02). Among repeat PNBx (n=777), complication rates were comparable to initial PNBx. On multivariable analysis, patient race, procedure year, diabetes (OR 1.96, 95%CI 1.31-2.91, p<0.01), transrectal approach (OR 3.52, 95%CI 1.29-9.64, p=0.01), and recent hospitalization (OR 2.03, 95%CI 1.43-2.89, p<0.01) were significantly associated with infections. Median total charge for infectious complications was $4,129 (interquartile range $711-$19,185).

Conclusions

Across New York State, post-PNBx infectious complications have increased over time. Risk factors for infectious complications such as diabetes, recent hospitalization, and the transrectal approach may help clinicians to select patients who are most likely to benefit from infection-reducing interventions such as transperineal approach and targeted prophylaxis.

Funding

None.