Non-elective percutaneous nephrostomy (PCN) service in a tertiary uroradiology centre: Can radiologists and urologists agree on timing?
| Autor: | J.S. Tuck, A.J. Bradley, S.Y. Liong |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Working hours medicine.medical_specialty Time Factors Referral medicine.medical_treatment Patient demographics Radiography Interventional Statistics Nonparametric Tertiary Care Centers Out of hours medicine Humans Radiology Nuclear Medicine and imaging Major complication Practice Patterns Physicians' Aged Nephrostomy Percutaneous Aged 80 and over Analysis of Variance Catheter insertion business.industry General Medicine Middle Aged Surgery Catheter Treatment Outcome Percutaneous nephrostomy Regression Analysis Female business Biomarkers |
| Zdroj: | Clinical Radiology. 68:e447-e452 |
| ISSN: | 0009-9260 |
| DOI: | 10.1016/j.crad.2012.07.022 |
| Popis: | Aim To assess agreement between uroradiologists and urologists with regards to the timing of non-elective percutaneous nephrostomy (PCN) catheter insertion, and whether any delay produced unacceptable complications. Materials and methods Standardized data collection forms detailing patient demographics, indications for PCN catheter insertion, blood results, procedural details, and immediate complications were completed by uroradiologists. At the time of referral, patients were stratified by both radiologists and urologists into three groups as follows: group 1 = PCN within 6 h; group 2 = PCN between 6 and 24 h; and group 3 = PCN between 24 and 48 h. Results One hundred and eighteen non-elective PCN catheter insertions were performed over 2 years. Radiologists stratified 12 patients (10.2%) into group 1, 65 (55.1%) patients into group 2, and 41 (34.7%) patients into group 3. Urologists stratified 14 (11.9%) patients into group 1, 68 (57.6%) patients into group 2, and 36 (30.5%) patients into group 3. There was good agreement between radiologist and urologists (κ = 0.865) on stratification in all but nine (7.6%) cases. Ninety-four point one percent of PCN catheters were inserted within the timeframe stratified by radiologists and urologists, or sooner. Sepsis was associated with a shortened timeframe. Elevated international normalized ratio (INR; >1.5) resulted in an increased timeframe. A major complication rate of 3% is within recommended limits. Fourteen percent of PCN catheter insertions were inserted outside normal working hours. Urgency stratification has decreased the number of cases performed out of hours. Conclusion Radiologists and urologists had good agreement on stratification with an acceptable major complication rate of 3%. |
| Databáze: | OpenAIRE |
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