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Study reveals
high death toll after severe Urinary
complications men over 45
Newswise — As many as one
in four men admitted to hospital with acute
urinary retention will die within a year,
finds a study published on bmj.com today.
The risk of death in
men after acute urinary retention is close
to that seen in patients who had a broken
hip. The problem is set to get worse as the
population ages, warn the researchers.
Acute urinary retention
(AUR) is the sudden inability to pass urine
and is often a progression of benign
prostatic hyperplasia (an increase in size
of the prostate in middle-aged and elderly
men which can interfere with the normal flow
of urine). It is a medical emergency and is
thought to be linked to the presence of
other disorders such as high blood pressure
and diabetes.
So to investigate the
risk of death associated with AUR,
researchers analysed data on all men aged
over 45 years who were admitted to NHS
hospitals in England with a first episode of
AUR between 1998 and 2005. Mortality in the
first year after AUR was compared to
mortality among the general male population
of similar age.
During the study
period, 176,046 men over 45 were admitted to
hospital with primary AUR.
Mortality among these
men was very high. One in seven men with
spontaneous AUR (no evidence of
precipitating factors other than benign
prostatic hyperplasia) and one in four with
precipitated AUR died in the first year.
The risk of dying
increased with age and the presence of other
disorders (comorbidity). Consequently, about
half the men aged over 85 years with
comorbid conditions died within the first
year after AUR.
Overall mortality at
one year in men admitted to hospital for AUR
was two to three times higher than for the
general male population. However, in men
aged between 45 and 54 years with
precipitated AUR, there was an almost
24-fold increase in mortality compared to
the general population.
The authors conclude
that mortality of hospitalised men with AUR
is high and increases strongly with age and
the presence of other conditions. As a
result, patients with AUR may benefit from
urgent multi-disciplinary care to identify
and treat comorbidity early.
An accompanying
editorial discusses the importance of this
study and supports the call for
multidisciplinary care in these men.
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