{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:31:49Z","timestamp":1777588309485,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Transurethral resection of prostate (TURP) remains the gold standard for the treatment of benign prostatic hyperplasia, but it is associated with complications. The association of health care resource utilization (HRU) and TURP has been poorly studied. We seek to evaluate HRU in patients undergoing TURP and identify factors contributing to outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The National Surgical Quality Improvement Program (NSQIP) database was reviewed from 2012 to 2018 for TURP by Current Procedural Terminology code. All data will be deidentified with IRB exemption. HRU was defined as discharge to continued care, unplanned readmission within 30 days, or prolonged length of stay (LOS) (&gt;75th percentile). We included preoperative variables, including age, body mass index, diabetes, and ASA class (a classification system to assess for fitness of patients perior to surgery). Operative duration (OD) was broken into deciles by minutes. Preoperative characteristics and outcomes were compared against OD. Predictors of HRU were found using a stepwise multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 38,749 patients were included. The following variables were significantly associated with OD (values are three shortest and three longest deciles, respectively): any HRU (35.9%, 32.4%, 31.4% and 32.4%, 33.7%, 37.6%) and prolonged LOS (31.3%, 27.6%, 26.5% and 28.0%, 30.4%, 34.1%). Findings in the first decile seemed to be an outlier, as shown in\n                      <jats:xref ref-type=\"fig\">Figure 1<\/jats:xref>\n                      . Complications associated with OD are shown in\n                      <jats:xref ref-type=\"fig\">Figure 2<\/jats:xref>\n                      . On multivariable analysis, patients with OD &gt;58 minutes were more likely to have increased HRU; odds ratio 1.22, 1.33, 1.54, and 1.78 for deciles 58\u201366, 67\u201378, 78\u201399, and &gt;100, respectively; p80, chronic obstructive pulmonary disease, dyspnea, hypertension, diabetes, not functionally independent, ASA class III and IV-V, and dirty\/infected wound class,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.005.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:fig fig-type=\"figure\" orientation=\"portrait\" position=\"float\">\n                        <jats:label>FIG. 1.<\/jats:label>\n                        <jats:caption>\n                          <jats:p>\n                            HRU compared against operative duration by deciles. Any HRU was significantly associated with greater OD (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009&lt;\u20090.001). Of those who required OD &gt;100 minutes, 37.6% required increased HRU compared with 32.4% in second decile. LOS was the most used; HRU was found in 34.1% of patients with OD &gt;100 minutes, compared with 27.6% in the second decile. The first decile appears to be outlier. HRU\u2009=\u2009health care resource utilization; LOS\u2009=\u2009length of stay; OD\u2009=\u2009operative duration. Color graphics are available online.\n                          <\/jats:p>\n                        <\/jats:caption>\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" orientation=\"portrait\" position=\"float\" xlink:href=\"10.1089_end.2022.0134-fig1.jpg\"\/>\n                      <\/jats:fig>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:fig fig-type=\"figure\" orientation=\"portrait\" position=\"float\">\n                        <jats:label>FIG. 2.<\/jats:label>\n                        <jats:caption>\n                          <jats:p>\n                            <jats:bold>(a)<\/jats:bold>\n                            Total complications compared against operative duration in patients undergoing TURP. Any complication was found to be significantly associated with increased OD,\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009&lt;\u20090.001. Complications included SSI, sepsis\/septic shock, cardiac event, myocardial infarction, pneumonia, DV, renal failure\/insufficiency, unplanned intubation, transfusion, UTI, return to OR, or death within 30 days.\n                            <jats:bold>(b)<\/jats:bold>\n                            Complications compared against operative duration in patients undergoing TURP. Those significantly associated with increased OD included sepsis\/septic shock (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009=\u20090.0121), pneumonia (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009=\u20090.0317), DVT (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009=\u20090.0498), transfusion (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009&lt;\u20090.01), unplanned intubation (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009=\u20090.0222), and return to OR (\n                            <jats:italic toggle=\"yes\">p<\/jats:italic>\n                            \u2009=\u20090.0444). DVT\u2009=\u2009deep vein thrombosis; OR\u2009=\u2009operating room; SSI\u2009=\u2009surgical site infection; TURP\u2009=\u2009transurethral resection of prostate; UTI\u2009=\u2009urinary tract infection. Color graphics are available online.\n                          <\/jats:p>\n                        <\/jats:caption>\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" orientation=\"portrait\" position=\"float\" xlink:href=\"10.1089_end.2022.0134-fig2.jpg\"\/>\n                      <\/jats:fig>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>OD is an independent predictor of HRU in patients undergoing TURP and is more modifiable than other preoperative variables associated with increased HRU. Patients in the longest decile were more likely to have complications and increased HRU. Further study is needed to evaluate causation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2022.0134","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T05:34:05Z","timestamp":1655357645000},"page":"1322-1330","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating Factors That Influence Health Care Resource Utilization in Transurethral Resection of Prostate"],"prefix":"10.1177","volume":"36","author":[{"given":"Rebecca","family":"Edwins","sequence":"first","affiliation":[{"name":"College of Medicine, University of Kentucky, Lexington, Kentucky, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Bettis","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Kentucky, Lexington, Kentucky, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0024-6046","authenticated-orcid":false,"given":"Andrew M.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Urology, Veteran Affairs Medical Center, Lexington, Kentucky, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,10,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.1150"},{"key":"e_1_3_4_3_2","unstructured":"NHE Fact Sheet | CMS. Available from: https:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/NationalHealthExpendData\/NHE-Fact-Sheet [Last accessed: April 8 2022]."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.15927"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000003122"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000155709.37840.fe"},{"issue":"1","key":"e_1_3_4_7_2","first-page":"1","article-title":"Benign prostatic hyperplasia: Epidemiology, economics and evaluation","volume":"22","author":"Vuichoud C","year":"2015","unstructured":"Vuichoud C, , Loughlin KR. Benign prostatic hyperplasia: Epidemiology, economics and evaluation. Can J Urol, 2015; 22(Suppl. 1):1\u20136.","journal-title":"Can J Urol"},{"key":"e_1_3_4_8_2","unstructured":"Surgery\u2014Urology Care Foundation. Available from: https:\/\/www.urologyhealth.org\/urology-a-z\/b\/benign-prostatic-hyperplasia-(bph)\/surgery [Last accessed: January 13 2022]."},{"key":"e_1_3_4_9_2","unstructured":"BPH: Costs and Treatment Outcomes. AJMC. Available from: https:\/\/www.ajmc.com\/view\/apr06-2290ps141-s148 [Last accessed: August 3 2021]."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-017-1700-7"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-018-0104-3"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.01.047"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2021.1893380"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-019-0907-3"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/RRU.S277480"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-25069-5"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15191"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000019617"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0233"},{"issue":"3","key":"e_1_3_4_20_2","first-page":"10","article-title":"MP17\u201316 operative duration during urology oncologic cases as independent predictor of increased postoperative healthcare utilization","volume":"206","author":"Morin J","year":"2021","unstructured":"Morin J, , Bettis A, , Harris A. MP17\u201316 operative duration during urology oncologic cases as independent predictor of increased postoperative healthcare utilization. J Urol, 2021; 206(Suppl. 3); doi:10.1097\/JU.0000000000002002.16.","journal-title":"J Urol"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0066"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2018.06.005"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.09.034"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.01.54"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.09.007"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.10.086"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2018.0266"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0592"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2022.0134","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2022.0134","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2022.0134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:13:51Z","timestamp":1777407231000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2022.0134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1089\/end.2022.0134"],"URL":"https:\/\/doi.org\/10.1089\/end.2022.0134","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}