PCNL data was obtained from the Premier Hospital Database, a nationally representative hospital discharge database. A multivariable regression model was used to adjust for potential confounders.
This study identified a total of 19,985 patients undergoing PCNL between 2003-2015. There was 18.5% access to cases by urologists. RA were performed by high-volume surgeons performed (37% vs. 9.8% p<0.001) and hospitals with <400 beds (19.1% vs 17.9% p=0.04). There was an association between RA performed by a urologist and lower 90-day complication rate (16.9% vs 18.8% p1⁄40.008) and lower rates of prolonged hospitalization >2 days (31.6% vs 68.4%, p<0.001). Multivariable analysis showed an association between RA performed by a urologist and lower rates of complication (Clavien 1-5), shorter hospitalization (<2 days) and lower direct admission costs (<$12,515).
Although high-volume urologists are more likely to obtain their own RA, in the U.S., percutaneous access before PCNL is performed by a urologist minority of the time. This study concluded that RA by a urologist is associated with lower overall complications, shorter hospitalizations, and lower direct hospital costs.
Presented By: Ruslan Korets
Authors: Ruslan Korets*, Jacqueline M Speed, Ye Wang, Steven L Chang, Boston, MA
Affiliation: New York, NY
Written By: Rita Derderian, University of California, Irvine for UroToday.com
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA