Predictors of Readmission following Outpatient Urological Surgery

Rambachan, Aksharananda; Matulewicz, Richard S.; Pilecki, Matthew; Kim, John Y.S.; Kundu, Shilajit

doi:10.1016/j.juro.2013.12.053

Cited by 58 publications

(60 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our analysis, only the ASA score was independently associated (p < 0.01) with hospitalization with 44% of patients with ASA score III who have been admitted to inpatient ward. The results of our study seem to be similar to those observed by Rambachan et al [21]. A multiinstitutional multivariate analysis of patient factors that contribute to readmission after outpatient urological surgery showed that cancer history, bleeding disorders, and ASA score III-IV were significant predictors of readmission.…”

Section: Discussionsupporting

confidence: 91%

Predictors of Hospitalization After Ureteroscopy Plus Elective Double-J Stent as an Outpatient Procedure

et al. 2018

View full text Add to dashboard Cite

Purpose: To evaluate the safety and feasibility of ureteroscopy plus elective double-J stent as an outpatient procedure in an unselected population with regard to the treatment for ureteral calculi and to present a multivariate analysis of factors predict hospitalization. Materials and Methods: Ureteroscopy was performed as an outpatient procedure on 308 consecutive patients with ureteral stones. Contraindication for day case surgery was the only exclusion criteria from the study. All causes that led to immediate hospitalization were recorded; at the same time, all causes of hospitalization that occurred within 72 h from the procedure were also recorded and included in the final analysis. Results: The overall stone-free rate and the rate of hospitalization were 94.5 and 9.7% respectively. Intraoperative complications were observed in 16 patients (5.1%). In terms of the variables related to hospitalization, the univariate analysis showed a statistical significant association between the American Society of Anesthesiologists (ASA) score (p < 0.001) and operative time (p = 0.018). At multivariate analysis, the only independent factor predictor of hospitalization was the ASA score (p < 0.001). Conclusions: In our experience, semirigid ureteroscopy is a safe and effective treatment that is independent of intraoperative local conditions or stone size. Elective Double-J stenting avoids major complications as the first reason for hospitalization. We suggest that ASA score > 2 should be taken into account when ureterorenoscopy is planning as an outpatient procedure.

show abstract

Section: Discussionsupporting

confidence: 91%

Predictors of Hospitalization After Ureteroscopy Plus Elective Double-J Stent as an Outpatient Procedure

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Past research on the association between smoking status and readmission rates has produced equivocal results. [26][27][28][29][30][31][32][33][34] Many studies have examined commonly collected demographic variables. It has been reported that increasing age could potentially serve as a predictor of all-cause hospital readmissions, especially in patients over the age of 65.…”

Section: Discussionmentioning

confidence: 99%

Risk predictors for hospital readmission in a low socio-economic and underserved population

Couch

Peterson

Bowden

et al. 2018

JHA

View full text Add to dashboard Cite

Objective: Hospital readmissions are significant and potentially preventable sources of healthcare cost in the United States. The Affordable Care Act (ACA) establishes the Hospital Readmissions Reduction Program (HRRP) in an attempt to reduce readmissions by penalizing institutions whose 30-day readmission rates are above the national average. The current study examines demographic and clinical variables associated with early hospital readmission in a low socioeconomic status, underserved population. Methods: A secondary data analysis was conducted of 2,536 patients from the acute primary care facilities who were hospitalized. Age, sex, race, ethnicity, smoking status, systolic blood pressure, diastolic blood pressure, body temperature, pulse rate, and days to follow up visit were analyzed in a sample of 2,536 hospitalized patients at or below 200% of federal poverty guidelines in Central Texas to determine association with risk of 0-30-(30), 31-60-(60) and 61-90-(90) day all-cause readmission. Results: Multinomial statistical analysis found pulse rate was associated with 30-, 60-, and 90-day readmission as compared to a control group. Days to follow-up were associated with decreased risk of readmission in all groups, and passive smoking status was associated with decreased risk of 90-day readmission as compared to a control group. Conclusions: Results offer healthcare providers with tools for potentially identifying patients at elevated risk for readmission in a disadvantaged population and suggest further investigation of other clinical and laboratory variables as predictors of readmission risk.

show abstract

“…Many studies in the literature have investigated the reasons for re-admissions and the financial impact of readmissions (4,5). The evaluation of these factors in the prediction and prevention of re-admissions can undoubtedly make a significant contribution.…”

Section: Discussionmentioning

confidence: 99%

Which Factors Affect the Hospital Re-admission After Treatment Approaches to Urethral Strictures?

Girgin¹

2017

jus

View full text Add to dashboard Cite

Objective: To investigate patient-and procedure-related factors associated with hospital re-admission following urethral manipulations for the treatment of urethral strictures. Materials and Methods: Data of patients who underwent dilation or internal urethrotomy for urethral strictures between 2011 and 2016 were retrospectively analyzed. Patients who were admitted to our institute for any reason within one month after hospital discharge were evaluated. The patient-and procedure-related factors affecting the readmission rates were revealed by multiple binary logistic regression using stepwise backward elinimination. Results:The average age of 76 male patients was 61.7±14.4 years. The mean maximal flow rate at preoperative uroflowmetry was 6.01±4.3 and the median American Society of Anesthesiologists score was 2.38. The process was the first for 45 (59.2%) patients, the second for 16 (21.1%) patients, the third for 9 (11.8%) patients, and the fourth for 6 (7.9%) patients. Amplatz dilators, cold knife and Ho:YAG laser were used in 50%, 27.6% and 22.4% of patients, respectively. The mean length of hospital stay was 0.89±0.31 days, and the complication rate was 19.7% (15/76). The mean urethral catheter dwell time was 8.9±14.2 day. Overall, the procedure was successful in 61 (80.3%) patients and failed (Q max <15 mL/sec) in 19.7% of the cases. Fifteen (19.7%) patients were re-admitted, while 2 (2.6%) patients among them were re-hospitalized for further treatment. Comorbidity and age were independent predictors of re-admission. Conclusion: We found that younger age and lower comorbidities predicted hospital re-admission following procedures for urethral strictures. Keywords: Urethral strictures, re-admission, risk factor Amaç: Üretral darlıklara müdahale edildikten sonra hastaneye tekrar başvuru nedenleri ile ilişkili hasta ve prosedüre bağlı faktörleri araştırmaktır. Gereç ve Yöntem: 2011 ile 2016 yılları arasında üretra darlığı nedeni ile dilatasyon veya internal üretrotomi uygulanan hastaların tıbbi kayıtları retrospektif olarak incelendi. Hastaneden taburcu olduktan sonraki 30 gün içinde hastaneye herhangi bir sebeple yeniden başvuran hastalar değerlendirildi. Tekrar başvuru oranlarını etkileyen hasta ve prosedüre bağlı faktörler, geriye doğru kademeli çoklu ikili lojistik regresyon analizi kullanılarak ortaya çıkarıldı. Bulgular: Yetmiş altı erkek hastanın yaş ortalaması 61,7±14,4 yıldı. Preoperatif üroflowmetride ortalama maksimal akım hızı 6,01±4,3, ortalama Amerikan Anesteziyologları Derneği skoru 2,38 idi. Kırk beş (%59,2) hastada birinci, 16 (%21,1) hastada ikinci, 9 (%11,8) hastada üçüncü, 6 (%7,9) hastada dördüncü kez işlem yapıldı. Amplatz dilatörleri, soğuk bıçak ve Ho:YAG lazeri sırasıyla %50, %27,6 ve %22,4 hastalarda kullanıldı. Ortalama yatış süresi 0,89±0,31 gün, komplikasyon oranı %19,7 (15/76) idi. Ortalama uretral kateterin kalma süresi 8,9±14,2 gündü. Toplam 61 (%80,3) hastada başarı elde edildi. Olguların %19,7'sinde işlem başarısız oldu (Q maks <15 mL/sn). On beş (%19,7) hasta hastaneye tekrar...

show abstract

Predictors of Readmission following Outpatient Urological Surgery

Cited by 58 publications

References 21 publications

Predictors of Hospitalization After Ureteroscopy Plus Elective Double-J Stent as an Outpatient Procedure

Predictors of Hospitalization After Ureteroscopy Plus Elective Double-J Stent as an Outpatient Procedure

Risk predictors for hospital readmission in a low socio-economic and underserved population

Which Factors Affect the Hospital Re-admission After Treatment Approaches to Urethral Strictures?

Contact Info

Product

Resources

About