title: Complications after prostate biopsy: data from SEER-Medicare.
abstract: OBJECTIVE
  More than 1 million prostate biopsies are performed annually among Medicare beneficiaries. We determined the risk of serious complications requiring hospitalization. We hypothesized that with emerging multidrug resistant organisms there may be an increasing risk of infectious complications.
  
  
  METHODS
  In a 5% random sample of Medicare participants in SEER (Surveillance, Epidemiology and End Results) regions from 1991 to 2007 we compared 30-day hospitalization rates and ICD-9 primary diagnosis codes for admissions between 17,472 men who underwent prostate biopsy and a random sample of 134,977 controls. Multivariate logistic and Poisson regression were used to examine the risk and predictors of serious infectious and noninfectious complications with time.
  
  
  RESULTS
  The 30-day hospitalization rate was 6.9% within 30 days of prostate biopsy, which was substantially higher than the 2.7% in the control population. After adjusting for age, race, SEER region, year and comorbidities prostate biopsy was associated with a 2.65-fold (95% CI 2.47-2.84) increased risk of hospitalization within 30 days compared to the control population (p <0.0001). The risk of infectious complications requiring hospitalization after biopsy was significantly greater in more recent years (p(trend) = 0.001). Among men undergoing biopsy, later year, nonwhite race and higher comorbidity scores were significantly associated with an increased risk of infectious complications.
  
  
  CONCLUSIONS
  The risk of hospitalization within 30 days of prostate biopsy was significantly higher than in a control population. Infectious complications after prostate biopsy have increased in recent years while the rate of serious noninfectious complications is relatively stable. Careful patient selection for prostate biopsy is essential to minimize the potential harms.
authors.affiliation: Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. stacyloeb@gmail.com
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.forename: H Ballentine
authors.initials: HB
authors.lastname: Carter
authors.forename: Sonja I
authors.initials: SI
authors.lastname: Berndt
authors.forename: Winnie
authors.initials: W
authors.lastname: Ricker
authors.forename: Edward M
authors.initials: EM
authors.lastname: Schaeffer
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects*; D015897:Comorbidity; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology*; D018426:SEER Program; D013530:Surgical Wound Infection / Q000453:epidemiology*; D014481:United States