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.
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.
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.
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.
Investigative and clinical urology. 2018 Aug 31 [Epub]
Manoj Kumar, Siddharth Pandey, Ajay Aggarwal, Deepanshu Sharma, Gaurav Garg, Samarth Agarwal, Ashish Sharma, Satyanarayan Sankhwar
Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.