Unplanned 30-day readmission rates in patients undergoing endo-urological surgeries for upper urinary tract calculi

Abstract

PurposeTo see the 30-day unplanned readmission rates in patients underdoing endo-urological surgeries for upper urinary tract calculi we conducted this retrospective study at King George's Medical University, Lucknow, India. Unplanned readmissions not only add to healthcare costs but also are bothersome for the patients. There are many studies on 30-day unplanned readmissions in general surgical patients. Although similar studies have been done in certain urological procedures, no study has reported readmission rates or its risk factors in patients undergoing surgeries for upper urinary tract calculi.Materials and MethodsWe retrospectively reviewed our prospectively maintained database from 1st January 2009 to 31st December 2017, for the patients who underwent endo-urological procedures for upper urinary tract calculi and identified the patients who were re-admitted within 30 days of discharge.ResultsOut of the total 3,209 patients undergoing endo-urological procedures for upper urinary tract calculi 56 were re-admitted. The readmission rate was 1.74% over the study period. The most common etiology for readmission was sepsis followed by hematuria. The significant risk factors for readmission in bivariate analysis included male gender, age >65 years, current smoking, chronic obstructive pulmonary disease, diabetes mellitus, bleeding disorder, prior cardiac disease, and American Society of Anesthesiologists (ASA) class ≥3. In multivariate risk adjusted logistic regression analysis ASA class ≥3 was the only independent risk factor for readmission.ConclusionsThe readmission rates in endo-urological procedures for urolithiasis are less compared to other procedures. ASA class ≥3 is the most important independent predictor of unplanned 30-day readmissions.

Extracorporeal shock wave lithotripsy: Prematurely falling out of favour? A 7 year retrospective study from an Australian high‐volume centre

“…Our overall complication rate of 9% is in keeping with that reported in the literature 12,13 . Despite a significant number of large stones treated with ESWL, this is not the typical practice of our centre, which utilises PCNL and pyeloscopy more commonly in these cases.…”

“…Our ESWL clearance rates of 84.4% and 63.5%, respectively, support this recommendation and cement this as a good treatment option. Furthermore, reported complications for endoscopic treatment appear higher than ESWL 12,13 . The noninvasive nature of ESWL and reduced cost per treatment provide further support to the legitimacy of ESWL as a viable option whose practice should not be lost.…”

“…Our overall complication rate of 9% is in keeping with that reported in the literature. 12 , 13 Despite a significant number of large stones treated with ESWL, this is not the typical practice of our centre, which utilises PCNL and pyeloscopy more commonly in these cases. Ureteric stenting is utilised in these cases to reduce complications such as steinstrasse, and stent‐related representations are likely responsible for the higher incidence of complications seen in this group.…”

“…Furthermore, reported complications for endoscopic treatment appear higher than ESWL. 12,13 The noninvasive nature of ESWL and reduced cost per treatment provide further support to the legitimacy of ESWL as a viable option whose practice should not be lost.…”

Preventing Catheter Related Bladder Discomfort (CRBD) in male patients undergoing Lower Urinary tract surgery with Bilateral Pudendal Nerve Block:A Randomized Controlled Trial

“…1 This high rate of complications is thought to be due to the large quantity of blood loss during these surgical procedures, which causes clot retention and prevents urine output. 2 Irrigation with three-way large-bore urinary catheters is frequently used to prevent clot retention. 3 These large urinary catheters irritate the bladder mucosa, generating involuntary bladder contractions through urothelial muscarinic receptors, resulting in catheter-related bladder discomfort (CRBD).…”