Unplanned 30-Day Encounters After Ureterorenoscopy for Urolithiasis
| Autor: | Ramakrishna Venkatesh, Alethea Paradis, Joel Vetter, Robert S. Figenshau, Kefu Du, Robert S. Wang, Alana Desai |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Ureteral Calculi Urology Operative Time 030232 urology & nephrology 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Chart review Ureteroscopy Humans Medicine Aged Retrospective Studies Pain Postoperative Renal stone medicine.diagnostic_test business.industry General surgery Middle Aged humanities 030220 oncology & carcinogenesis Urinary Tract Infections Female business |
| Zdroj: | Journal of Endourology. 32:1100-1107 |
| ISSN: | 1557-900X 0892-7790 |
| Popis: | To identify avoidable predictors of postureteroscopy (URS) unplanned encounters and to minimize 30-day encounters.We performed retrospective chart review and telephone surveys on patients who underwent URS for urolithiasis between January and June 2016. Univariate and multivariable analyses evaluated for potential predictors of unplanned encounters.Of 157 patients, there were 44 (28.0%) unplanned patient-initiated clinical phone calls, 23 (14.6%) emergency department (ED) visits, and 8 (5.1%) readmissions, with pain being the most common complaint during the encounters. Factors associated with a higher rate of phone calls include first-time stone procedure (36.6% vs 20.9%, p = 0.029), outpatient status (30.3% vs 0%, p = 0.021), intraoperative stent placement (31.2% vs 0%, p = 0.006), and stent removal at home (58.8% vs 28.8%, p = 0.014). Factors associated with increased rate of ED visits were first-time stone procedure (22.5% vs 8.1%, p = 0.011) and ureteral access sheath (UAS) usage (29.6% vs 11.8%, p = 0.018). Factors associated with a higher rate of readmissions were lower body mass index (23.9 vs 29.7, p = 0.013), bilateral procedure (20.0% vs 2.9%, p = 0.010), and UAS usage (14.8% vs 3.1%, p = 0.032). Stone burden, operative time, Charlson comorbidity index, and preoperative urinary tract infection were not significantly associated with postoperative encounters.Pain, first-time stone treatment, presence of a ureteral stent, outpatient status, bilateral procedures, and UAS usage were common reasons for postoperative encounters after URS. Appropriate perioperative patient education and counseling and adequate pain management may minimize these encounters and improve treatment quality and patient satisfaction. |
| Databáze: | OpenAIRE |
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