Causes and Risk Factors for Hospital Readmission in Patients with Ureteral Stones Treated With Transurethral Lithotripsy

Document Type : Original Article

Authors

1 Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Medical Informatics Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Urinary tract stones are recognized as the third most prevalent disease in urology. Transurethral lithotripsy (TUL) is the most prevalent surgical modality for ureteral stones. Some patients experience hospital readmission and possibly another surgical intervention after TUL. The present study aimed to assess the causes and risk factors of readmission in patients with ureteral stones treated with TUL.
Materials and Methods:
This cross-sectional study was conducted on all the patients who underwent TUL in Imam Reza Hospital in Mashhad, northeast of Iran, from March 2018 to September 2019. The case group consisted of 67 patients who were hospitalized due to primary urinary stone-related complications. The patients who were admitted for the removal of double J (DJ) catheter (n=118) were regarded as the control group.
Results:
The most common causes of hospital readmission were re-TUL for the removal of the remnant urinary stones when patients came back for DJ catheter removal (29.9%). The second and third causes of readmission were fever after DJ catheter removal (20.9%) and fever after TUL (14.9%). The main risk factors for hospital readmission were stone size, age, and male gender.
Conclusion:
As evidenced by the results of the present study, stone size, age, and male gender were the major risk factors for hospital readmission after TUL. The most common causes of readmission were re-TUL at the time of DJ catheter removal, fever after DJ catheter removal, and fever after TUL.

Keywords

References

1.             Alpay H, Gokce I, Özen A, Bıyıklı N. Urinary stone disease in the first year of life: is it dangerous? Pediatric surgery international. 2013; 29(3):311-6.
2.             Evan AP. Physiopathology and etiology of stone formation in the kidney and the urinary tract. Pediatric Nephrology. 2010;25(5):831-41.
3.             Khan SR, Kok DJ. Modulators of urinary stone formation. Front Biosci. 2004;9(629):1450-82.
4.             Kovshilovskaya B, Chi T, Miller J, Stoller ML. Systemic implications of urinary stone disease. Translational andrology and urology. 2012; 1(2):89.
5.             Bartoletti R, Cai T, Mondaini N, Melone F, Travaglini F, Carini M, et al. Epidemiology and risk factors in urolithiasis. Urologia internationalis. 2007;79(Suppl. 1):3-7.
6.             Hyams ES, Matlaga BR. Economic impact of urinary stones. Translational andrology and urology. 2014;3(3):278.
7.             Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT. CUA Guideline: Management of ureteral calculi. Canadian Urological Association Journal. 2015;9(11-12):E837.
8.             Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, et al. EAU guidelines on interventional treatment for urolithiasis. European urology. 2016;69(3):475-82.
9.             Ono Y, Ohshima S, Kinukawa T, Matsuura O, Hirabayashi S, Yamada S. Long-term results of transurethral lithotripsy with the rigid ureteroscope: injury of intramural ureter. The Journal of urology. 1989;142(4):958-60.
10.          Yarahmadi A, Mostafavi-Pour Z, Modaghegh M-HS, Azarpira N, Mousavian A, Bonakdaran S, et al. Association between serum vitamin D, hs-CRP, and prooxidant-antioxidant balance with anthropometric and biochemical parameters in patients with diabetic foot ulcers. Clinical Diabetology. 2020.
11.          Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World Journal of Urology. 2017;35(9):1301-20.
12.          Shafi H, Moazzami B, Pourghasem M, Kasaeian A. An overview of treatment options for urinary stones. Caspian journal of internal medicine. 2016;7(1):1.
13.          Imamura Y, Kawamura K, Sazuka T, Sakamoto S, Imamoto T, Nihei N, et al. Development of a nomogram for predicting the stone‐free rate after transurethral ureterolithotripsy using semi‐rigid ureteroscope. International Journal of Urology. 2013;20(6):616-21.
14.          Huffman J, Bagley D, Schoenberg H, Lyon E. Transurethral removal of large ureteral and renal pelvic calculi using ureteroscopic ultrasonic lithotripsy. The Journal of urology. 1983; 130(1):31-4.
15.          Taie K, Jasemi M, Khazaeli D, Fatholahi A. Prevalence and management of complications of ureteroscopy: a seven-year experience with introduction of a new maneuver to prevent ureteral avulsion. Urology journal. 2012; 9(1): 356-60.
16.          El-Nahas AR, Taha D-E, Elsaadany MM, Zahran MH, Hassan M, Sheir KZ. Hospital admission for treatment of complications after extracorporeal shock wave lithotripsy for renal stones: a study of risk factors. Urolithiasis. 2018;46(3):291-6.
17.          Southern JB, Higgins AM, Young AJ, Kost KA, Schreiter BR, Clifton M, et al. Risk factors for postoperative fever and systemic inflammatory response syndrome after ureteroscopy for stone disease. Journal of endourology. 2019;33(7): 516-22.
Journal of Patient Safety & Quality Improvement
Volume 9, Issue 2
April 2021
Pages 73-77

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