ABSTRACT
OBJECTIVE: To investigate whether treatment of overactive bladder (OAB), one comorbidity of nocturia, could reduce waking to void and improve other co-existing symptoms. METHODS: A prospective cohort study was conducted at Royal Melbourne Hospital. Participants received 12 weeks of standard treatment, including lifestyle interventions and pharmacotherapy. Outcome measures were nocturia episodes, severity of urinary urgency/incontinence, sleep quality, daytime somnolence, anxiety and depression scores, quality of life and change in blood pressure. RESULTS: Twenty participants completed the study. Nocturia frequency improved by one void per night. Overactive Bladder Symptom Score, sleep quality, first uninterrupted sleep time and systolic blood pressures improved. There were no significant changes in daytime somnolence, mood or quality of life. CONCLUSIONS: In this pilot study, nocturia and other co-morbid dysfunctions appeared to improve when the severity of OAB was reduced. Treatment of OAB co-morbid with nocturia reduces urinary symptoms and may improve sleep parameters and positively impact return to health.
Subject(s)
Nocturia/therapy , Urinary Bladder, Overactive/therapy , Urination , Aged , Blood Pressure , Comorbidity , Female , Health Status , Humans , Male , Middle Aged , Nocturia/diagnosis , Nocturia/epidemiology , Nocturia/physiopathology , Pilot Projects , Prospective Studies , Recovery of Function , Sleep , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/physiopathology , Time Factors , Treatment Outcome , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/epidemiology , Urinary Bladder, Overactive/physiopathology , Victoria/epidemiologyABSTRACT
AIM: Emergency department (ED) doctors are under time pressure to expedite decision-making. This task would seem more difficult in older patients who present atypically, have multiple comorbidities and require more diagnostic tests. This study aimed to investigate the rate of appropriate initial diagnosis of older ED patients admitted under medical units, and whether time was a factor. METHODS: Retrospective review of all patients admitted under medical units from ED over a one-month period was conducted. RESULTS: Four hundred ninety-three records were reviewed. Mean time to ED review was 87 minutes, and to medical registrar review, 409 minutes. Overall rate of appropriate initial diagnosis made by ED was 85.8%, with significantly lower rate detected in older patients. Overall rate for medical registrar was 94.5%. CONCLUSIONS: Admitted older ED patients received lower rates of appropriate initial diagnosis. Time may be a contributing factor to this lower rate. Length of stay was prolonged if initial diagnosis was inappropriate.
