The future of urology: nonagenarians admitted to a urological ward

Purpose To analyze the outcome of nonagenarians with urological conditions. As demographic changes will lead to a substantial rise of geriatric patients in need of health care services and as little is known on the outcome of these patients, we retrospectively analyzed a consecutive series of nonagenarians admitted to our urological ward. Materials and methods In a retrospective study we analyzed all nonagenarians admitted to our urological ward between 2014 and 2018. Patients were followed for 12 months and predictors for mortality were calculated. Results A total of 152 patients with a mean age of 92 years entered this study. The most frequent indications for admission were macrohematuria, bladder dysfunction, urinary tract infection, hydronephrosis and urinary retention. A history of bladder cancer was present in 18% and of renal cell cancer in 5% of patients. Prostate cancer was present in 21%. The most frequent invasive interventions were the insertion of an irrigation catheter, cystoscopy, bladder tumor resection and insertion of a DJ-catheter. The mean length of hospitalization was 6.5 days. In-house mortality was 9% and the 12 months mortality rate 45%. The strongest predictor for a 12 months mortality was the CSHA-Frailty Scale. Conclusion Urogerontology is one of the biggest challenges in our field. The cohort of nonagenarians studied herein demonstrates a high rate of invasive interventions, an acceptable length of hospitalization and an in-house mortality in the range of 9%. The 12 months mortality rate is almost 50% and predictors thereof, as elaborated, might aid in the disease management of this ever-increasing cohort.

Automated summary

This study retrospectively analyzed nonagenarians admitted to the urological ward, with the most common indications for admission being macrohematuria, bladder dysfunction, and urinary tract infection. The average age of patients was 92 years, with an in-house mortality rate of 9% and a 12 months mortality rate of 45%.