Investig Clin Urol.  2018 Sep;59(5):321-327. 10.4111/icu.2018.59.5.321.

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

• Kumar M
• Pandey S
• Aggarwal A
• Sharma D
• Garg G
• Agarwal S
• Sharma A
• Sankhwar S

• KMID: 2419415
• DOI: http://doi.org/10.4111/icu.2018.59.5.321

Abstract

PURPOSE
To 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 METHODS
We 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.
RESULTS
Out 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.
CONCLUSIONS
The 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.

Keyword

Patient readmission; Percutaneous nephrolithotomy; Ureteroscopy; Urinary calculi

MeSH Terms

Calculi*
Diabetes Mellitus
Health Care Costs
Heart Diseases
Hematuria
Hemorrhage
Humans
India
Logistic Models
Male
Nephrostomy, Percutaneous
Patient Readmission
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Risk Factors
Sepsis
Smoke
Smoking
Ureteroscopy
Urinary Calculi
Urinary Tract*
Urolithiasis
Smoke

Figure

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  Fig. 1 Readmission rates over the study period.

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