Clinical Scorecard: Prevalence, Predictors, and Outcomes of Gross Hematuria in Nonagenarian Patients in a Urological Setting
At a Glance
Category
Detail
Condition
Gross hematuria (GH) in nonagenarian patients
Key Mechanisms
GH linked to underlying urological pathologies (bladder cancer, prostate cancer, BPH, urinary tract infections) and influenced by anticoagulant/antiplatelet therapy
Target Population
Patients aged 90 years and older admitted to urological wards
Care Setting
Urological inpatient wards in hospital settings
Key Highlights
Nonagenarians represent a rapidly growing population with increasing urological disease burden.
GH is a common cause of hospital admission in nonagenarians and is associated with frailty and comorbidities.
Frailty assessed by the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS) predicts survival and clinical outcomes in this population.
Guideline-Based Recommendations
Diagnosis
Assess GH in nonagenarians considering underlying urological pathologies and anticoagulant/antiplatelet therapy.
Use geriatric screening tools such as CSHA-CFS to evaluate frailty and baseline function.
Management
Identify risk factors including age, sex, antithrombotic therapy, indwelling catheters, and history of bladder cancer to guide admission and treatment decisions.
Consider the impact of invasive procedures and catheter use on cognitive and physical decline.
Monitoring & Follow-up
Monitor changes in discharge status including survival, catheter dependence, and social service utilization.
Use CSHA-CFS score ≥5 to stratify risk and guide clinical decision-making.
Risks
Hospital admissions and invasive procedures may lead to cognitive decline, physical deconditioning, and increased dependency.
Anticoagulant and antiplatelet therapies increase risk of GH and related complications.
Patient & Prescribing Data
Nonagenarian patients admitted to urological wards
High prevalence of antithrombotic therapy use influences GH occurrence; treatment decisions should balance bleeding risk and underlying urological conditions.
Clinical Best Practices
Incorporate frailty assessment (CSHA-CFS) routinely in nonagenarian urological patients to inform prognosis and care planning.
Evaluate and manage antithrombotic therapy carefully in patients presenting with GH.
Plan discharge and social support services based on changes in dependency and frailty status to maintain patient autonomy.
Board-certified urologist Yvonne K. P. Koch, M.D., has joined Baptist Health Urology. She specializes in general urology and male and female voiding dysfunction.
