Evidence map›Paper›PMID 39877559›Full record

ArticleBJUI compass2025

Outcomes following intradetrusor onabotulinumtoxinA in a national cohort of nursing home residents.

Leo D Dreyfuss, Farnoosh Nik-Ahd, Lufan Wang, Abigail Shatkin-Margolis, Kenneth Covinsky, W John Boscardin, Anne M Suskind

Abstract read
In one paragraph

Article in BJUI compass, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Leo D DreyfussDepartment of Urology Weill Cornell Medical Center New York NY USA.ORCID https://orcid.org/0000-0002-8598-3653
Farnoosh Nik-AhdDepartment of Urology University of California, San Francisco San Francisco CA USA.
Lufan WangDepartment of Urology University of California, San Francisco San Francisco CA USA.
Abigail Shatkin-MargolisDepartment of Obstetrics and Gynecology University of California San Francisco CA USA.
Kenneth CovinskyDivision of Geriatrics University of California San Francisco CA USA.
W John BoscardinDepartment of Epidemiology and Biostatistics University of California San Francisco CA USA.
Anne M SuskindDepartment of Urology University of California, San Francisco San Francisco CA USA.ORCID https://orcid.org/0000-0002-8437-3861

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KENNETH E. COVINSKY · 2013 to 2026
$19.9M
UCSF-Kaiser Urological Epidemiology Research Career Development ProgramK12DK111028 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HUANG, ALISON · 2016 to 2025
$5.3M
Determinants of outcomes for older and frail older adults with refractory overactive bladderR56AG076501 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SUSKIND, ANNE M. · 2023 to 2023
$474k
NIA NIH HHS P30 AG044281NIA NIH HHS R56 AG076501NIDDK NIH HHS K12 DK111028
6 · The paper itself

Abstract

Objectives: To determine predictors of treatment success and complications following intradetrusor onabotulinumtoxinA injections among a large cohort of nursing home (NH) residents, representing one of the most frail and vulnerable populations in the United States. Materials and methods: This is a retrospective cohort study of long-stay NH residents who underwent onabotulinumtoxinA injections between 2014 and 2016. Residents were identified using the Minimum Data Set (MDS) linked to Medicare claims. Frailty was measured using the Claims-based Frailty Index and socioeconomic status using the Area Deprivation Index (ADI; higher ADI = increasing social deprivation). The primary outcome was treatment success, defined as repeat onabotulinumtoxinA injection within 1 year of index injection. Secondary outcomes included 30-day complications and urinary retention, defined as new indwelling urinary catheters identified on the MDS at 3 months. Results: OnabotulinumtoxinA injections were performed in 1683 NH residents. Mean age was 78.2 years, 74% were female and 22.8% had an indwelling urinary catheter at baseline. A total of 38.4% of residents had ≥1 30-day complication and 14.6% had a new catheter at 3 months. Repeat injections were performed in 34.3% of residents within 1 year. Repeat injections were more likely among residents who were female [adjusted relative risk (aRR) 1.29; 95% CI 1.08-1.54] and who had a baseline catheter (aRR 1.30; 95% CI 1.11-1.52). Residents who were ≥85 years (aRR 0.78; 95% CI 0.64-0.96) and those in the lowest quartile ADI (aRR 0.75; 95% CI 0.61-0.93) were less likely to undergo repeat injections. Conclusion: Among this population of NH residents, who are by definition frail and comorbid, rates of repeat onabotulinumtoxinA injections are comparable to retrospective analyses of younger adults and independent of frailty and comorbidity. Based on these findings, surgeons should consider the entire clinical picture when evaluating patients for onabotulinumtoxinA injections and should not necessarily exclude those who are frail or comorbid from this potentially quality-of-life-improving therapy.

Indexed as

botoxelderlyfrailtynursing homeOnabotulinumtoxinAoveractive bladder

Identifiers

PMID39877559
PMCPMC11771503

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.