(AJ) Urinary Retention and The Risk of Delirium Among Elderly Patients with Benign Prostatic Hyperplasia

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall E South

Publication Number: 652

Presenting Author(s)

Sheng-Yung Chang
– NCKU Institute of Clinical Pharmacy and Pharmaceutical Sciences, Tainan City, Taiwan

Co-Author(s)

Chin-Yao Shen
– NCKU Institute of Clinical Pharmacy and Pharmaceutical Sciences, Institute of Clinical Pharmacy and Pharmaceutical Sciences, Tainan, Tainan, Taiwan
Edward Lai, PhD
– Associate Professor, National Cheng Kung University, National Cheng Kung University, Tainan City, Tainan, Taiwan (Republic of China)

Background: Patients with benign prostatic hyperplasia (BPH) is manifested urinary retention (UR) that may lead to cystocerebral syndrome and delirium. However, the risk of delirium after UR treatment has not been well established.

Objectives: To assess the association between UR treatment and risk of delirium in patients with BPH.

Methods: We conducted a self-controlled cased series (SCCS) study using Taiwan’s National Healthcare Insurance Database (NHID). The pre-specified study period started from 2012 to 2018. We included elderly patients aged 65+ years at 2012 newly diagnosed with BPH and received BPH drugs, including alpha blockers (AB) and 5-alpha reductase inhibitors (5ARI), and an incident event of delirium during study period. The incident delirium was defined as those without a record before 2012. We classified all observed time into pre-exposure, early exposure, exposure, post-exposure, and non-exposure period. The incidence rate ratio (IRR) and 95% CIs were estimated to compare the risk of delirium within each period with unexposed period using conditional Poisson regression model.

Results: A total of 16,927 patients were identified. Compared to the non-exposure period, the IRR of delirium was 12.82 (95% CI: 11.94, 13.77), 3.45 (95% CI: 3.03, 3.92), 2.94 (95% CI 2.81, 3.07), 3.63 (95% CI 3.35, 3.93) for pre-exposure, early exposure, exposure, post exposure period, respectively. The subgroup analyses for the exposure by individual medications, patient sources, age groups, comorbidities showed consistent results. The highest IRR during pre-exposure period were also shown in sensitivity analyses excluding patients who died or received transurethral resection of prostate, including patients with long-term prescription only, extending early exposure period.

Conclusion: We found UR may associate with delirium in patients with BPH but the risk magnitude was largely reduced after treatment, suggesting a close monitoring is still required until the patients has recovered to baseline status.