ABSTRACT
BACKGROUND: Post-operative urinary retention (POUR) is most accurately determined by using ultrasound to measure bladder volume. The aim of this study was to define the risk factors of POUR in the recovery room in hospitalised patients. METHODS: An ultrasound-determined bladder volume ≥400 ml at arrival in the recovery room was used to define POUR. Multivariate regression analysis was used to identify patient and system factors linked to POUR in 773 consecutive hospitalised patients who had undergone orthopaedic, abdominal, gynaecological or plastic surgery without an indwelling urinary catheter. RESULTS: We found the incidence of POUR to be 13%. The lack of pre-operative voiding, use of regional anaesthesia, anaesthesia time >2 h and emergency surgery were all independent risk factors for POUR. CONCLUSIONS: The detected incidence of POUR at arrival in the recovery room was rather high but had easily identifiable risk factors. We recommend pre-operative voiding whenever possible. Routine bladder scanning at arrival in the recovery room should be considered, especially after spinal anaesthesia, emergency surgery or when the anaesthesia time exceeds 2 h.
Subject(s)
Postoperative Complications/epidemiology , Urinary Retention/epidemiology , Aged , Anesthesia Recovery Period , Databases, Factual , Female , Hospitalization , Humans , Male , Middle Aged , Norway/epidemiology , Odds Ratio , Postoperative Care , Postoperative Complications/diagnostic imaging , Postoperative Period , Recovery Room , Regression Analysis , Risk Factors , Ultrasonography , Urinary Bladder/anatomy & histology , Urinary Bladder/diagnostic imaging , Urinary Retention/diagnostic imagingABSTRACT
OBJECTIVE: To evaluate the frequencies, causes and costs related to hospital admissions for patients with Parkinson's disease (PD) and controls. METHODS: In a prospective cohort study, 108 patients with PD from a population-based prevalence study and 854 age- and sex-matched controls were followed regarding admissions to the Stavanger University Hospital over a period of 12 years. RESULTS: There was no significant difference regarding the number of patients admitted, number of admissions or length of stay between the two cohorts. Based on 2005 prices, the costs per person year of survival were EUR 3288 for patients with PD and EUR 2466 for control individual with incremental costs of EUR 822. However, the difference in costs was not statistically significant. The two cohorts had a different distribution of diagnoses causing hospital admissions. Patients with PD were more often admitted for PD-related symptoms and falls, while vascular disorders and cancer were substantially more common in control individuals. CONCLUSION: Hospitalization in PD does not induce incremental costs. The diagnoses causing hospital admissions were different in patients with PD as compared with controls. Our results indicate that cancer and vascular diseases might be less common in patients with PD than in the general population.
Subject(s)
Hospitalization/statistics & numerical data , Parkinson Disease , Patient Admission/statistics & numerical data , Aged , Costs and Cost Analysis , Denmark/epidemiology , Female , Humans , Male , Middle Aged , Parkinson Disease/diagnosis , Parkinson Disease/economics , Parkinson Disease/rehabilitation , Prevalence , RegistriesABSTRACT
BACKGROUND AND PURPOSE: To examine the relative risk (RR) for living in nursing homes for patients with Parkinson's disease (PD) compared with the general population and to ascertain society's costs related to nursing home placement for this patient group. METHODS: We evaluated the frequency of admission to nursing homes in a cross-sectional study and during a 12-year follow-up study of 108 patients with PD and 864 controls who were matched for age and sex. The RR for living in a nursing home was calculated at baseline and during follow-up. On the basis of 2007 prices, we estimated the costs per person year of survival for patients with PD and controls. RESULTS: The RR for living in a nursing home at baseline was 5.0 for patients with PD and 4.8 during follow-up. Patients with PD caused 4.8 times higher costs for nursing home placement with euro 18 875 versus euro 3978 per individual and year. The annual costs for institutional care of patients with PD in Norway were euro 132 million. CONCLUSION: Patients with PD have a substantially higher risk for living in nursing homes than the general population. This causes high costs to society. Therapeutic interventions to prevent or delay nursing home admissions are therefore important.
