EAU 2017: Follow Up Care After Emergency Department Visits For Kidneys Stones –a Missed Opportunity
Authors used Truven Health Analytics’ MarketScan Commercial Clams and Encounters Database to identify patients with an ED visit for kidney stones. Authors assessed whether a patient received outpatient services within 90 days of his/her primary ED visit. Additionally, they performed a multivariable logistic regression models to evaluate the association between receipt of post-ED follow-up care and ED revisit, as well as the initiation of secondary stone prevention.
A total of 70,294 patients with an ED visit for kidney stones were identified to fit the criteria to be included in the study. Of these, 48% had follow-up care within 90 days, over two-thirds of whom (68.3%) were seen by a urologist. While follow-up care receipt was not associated with lower ED revisit rates, as shown in the Figure below, patients had higher odds of performing a 24-hour urine collection [odds ratio (OR), 2.55; 95% confidence interval (CI), 2.23 to 2.92] and being prescribed preventive pharmacological therapy if they had an outpatient visit within 90 days of ED discharge. Odds of receiving secondary stone prevention were even higher when patients were seen by a urologist in follow-up.
As study confirms, it is well known that follow up and preventive procedures after initial stone presentation remains important to prevent subsequent renal colic events. We believe that improving patient communication and explaining them the importance of follow up procedures is crucial.
Dr. Ghani concluded that almost half of patients seen acutely in the emergency department for kidney stone acute renal attacks do not receive follow-up care. Given that this follow-up is associated with greater use of secondary stone prevention, efforts to enhance linkages across settings are needed in order to provide these patients more comprehensive care.
Speaker(s): Khurshid Ghani, MD
Authors: Hollingsworth J, Hollenbeck B.K., Ghani K.R.
at the #EAU17 - March 24-28, 2017- London, England