title: The state of TRUS biopsy sepsis: readmissions to Victorian hospitals with TRUS biopsy-related infection over 5 years.
abstract: OBJECTIVE
  To describe the incidence, morbidity and mortality of men who developed infectious complications requiring hospital admission following TRUS prostate biopsy in Victoria, Australia. Further it aimed to report the financial cost of these admissions.
  
  
  METHODS
  The Department of Health's Victorian Admitted Episodes Data Set was used to identify those patients who underwent TRUS biopsy in Victoria who were subsequently readmitted within 7 days to any Victorian hospital with infective complications from July 2007 to June 2012. All Victorian public and private hospitals were included. Patients were excluded if their biopsy was performed during a multi-day admission. Financial costing data was obtained where available from the Department Of Health and Human Services for readmissions with post-TRUS infection where available and adjusted to 2012 prices. Institutional ethics committee approval was granted for this study.
  
  
  RESULTS
  Thirty-four thousand eight hundred and sixty-five TRUS biopsies were performed in the 5-year period. 1276 (3.66%) were readmitted to a Victorian hospital within 7 days. 604 (1.73%) of these were readmitted with a biopsy-related infection. No significant trend in sepsis rates was seen in 5 years. The median readmission LOS was 4 days. The total burden of readmissions was 3 686 days over 5 years. One patient readmitted with a biopsy related infection died during that episode of care. 20 051 (57.51%) of biopsies resulted in a diagnosis of prostate cancer. Financial costing data was available for 218 (36%) of infectious readmissions with a mean cost per readmission were $7 362 AUD (£4137 or $6844 USD, 95% CI $6219-8505 AUD) or $1 256 AUD per day.
  
  
  CONCLUSIONS
  Infection following TRUS biopsy was associated with a readmission rate for infection of 1 in 57 biopsies, an excess of 3 686 bed days required over 5 years with a cost of $1 256 AUD per day. The rate of infection remained stable for the period examined.
authors.affiliation: Alfred Health, Melbourne, Vic., Australia.
authors.forename: Hedley
authors.initials: H
authors.lastname: Roth
authors.affiliation: Alfred Health, Melbourne, Vic., Australia.|Department of Surgery, Monash University, Melbourne, Vic., Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Millar
authors.affiliation: Alfred Health, Melbourne, Vic., Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.affiliation: North Eastern Melbourne Integrated Cancer Service, Melbourne, Vic., Australia.|Department of Health, Cancer Strategy and Development, Melbourne, Vic., Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Byrne
authors.affiliation: Department of Surgery, Monash University, Melbourne, Vic., Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Evans
authors.affiliation: Alfred Health, Melbourne, Vic., Australia.|Department of Surgery, Monash University, Melbourne, Vic., Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Grummet
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011471:Prostatic Neoplasms / Q000473:pathology*; D012044:Regression Analysis; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology*; D018084:Ultrasonography, Interventional; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*; D014739:Victoria
keywords: biopsy; infection; postoperative complications; prostatic neoplasms; sepsis