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Research

Mortality in men admitted to hospital with acute urinary retention: database analysis

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39377.617269.55 (Published 06 December 2007) Cite this as: BMJ 2007;335:1199
  1. James N Armitage, urology research fellow1,
  2. Nokuthaba Sibanda, research fellow2,
  3. Paul J Cathcart, urology registrar1,
  4. Mark Emberton, reader in interventional oncology3,
  5. Jan H P van der Meulen, reader in clinical epidemiology2
  1. 1Clinical Effectiveness Unit, Royal College of Surgeons of England, London WC2A 3PE
  2. 2Health Services Research Unit, London School of Hygiene and Tropical Medicine
  3. 3Division of Surgery and Interventional Science, University College Hospital, London NW1 2BU
  1. Correspondence to: J H P van der Meulen jan.vandermeulen{at}lshtm.ac.uk
  • Accepted 7 October 2007

Abstract

Objectives To investigate mortality in men admitted to hospital with acute urinary retention and to report on the effects of comorbidity on mortality.

Design Analysis of the hospital episode statistics database linked to the mortality database of the Office for National Statistics.

Setting NHS hospital trusts in England, 1998-2005.

Participants All men aged over 45 who were admitted to NHS hospitals in England with a first episode of acute urinary retention.

Main outcome measures Mortality in the first year after acute urinary retention and standardised mortality ratio against the general population.

Results During the study period, 176 046 men aged over 45 were admitted to hospital with a first episode of acute urinary retention. In 100 067 men with spontaneous acute urinary retention, the one year mortality was 4.1% in men aged 45-54 and 32.8% in those aged 85 and over. In 75 979 men with precipitated acute urinary retention, mortality was 9.5% and 45.4%, respectively. In men with spontaneous acute urinary retention aged 75-84, the most prevalent age group, the one year mortality was 12.5% in men without comorbidity and 28.8% in men with comorbidity. The corresponding figures for men with precipitated acute urinary retention were 18.1% and 40.5%. Compared with the general population, the highest relative increase in mortality was in men aged 45-54 (standardised mortality ratio 10.0 for spontaneous and 23.6 for precipitated acute urinary retention) and the lowest for men 85 and over (1.7 and 2.4, respectively).

Conclusions Mortality in men admitted to hospital with acute urinary retention is high and increases strongly with age and comorbidity. Patients might benefit from multi-disciplinary care to identify and treat comorbid conditions.

Footnotes

  • We thank the Department of Health for providing the hospital episode statistics data used in this study and Jim Lewsey, statistician at London School of Hygiene and Tropical Medicine and the Royal College of Surgeons of England, for his help with the extraction of the dataset.

  • Contributors: JNA, PJC, ME, and JHvdM designed the study; JNA and NS conducted the statistical analyses; JNA and JHvdM drafted the paper; NS, PJC, and ME commented on and contributed to the final version. JHvdM is guarantor.

  • Funding: JNA was supported by the Bob Young Research Fellowship, the Dunhill Medical Trust, and the Royal College of Surgeons of England research fellowship scheme. JvdM received a national public health career scientist award from the Department of Health and NHS research and development programme.

  • Competing interests: None declared.

  • Ethical approval: Not required.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

  • Accepted 7 October 2007
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