Analysis of factors affecting re-admission after retrograde intrarenal surgery for renal stone

• Published in: World journal of urology Vol. 37; no. 6; pp. 1205 - 1210
• Main Authors: Kim, Tae Jin, Lee, In Jae, Lee, Jung Keun, Lee, Hak Min, Jeong, Chang Wook, Hong, Sung Kyu, Byun, Seok-Soo, Oh, Jong Jin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2019; Springer Nature B.V
• Subjects: Adult; Aged; Body mass; Calculi; Demography; Emergency medical care; Female; Humans; Kidney Calculi - surgery; Kidneys; Lithiasis; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Nephrology; Oncology; Original Article; Patient Readmission - statistics & numerical data; Postoperative Complications - epidemiology; Retrospective Studies; Risk Factors; Surgery; Urologic Surgical Procedures - methods; Urology; Renal stone; Retrograde intrarenal surgery; Hospital readmission; Risk factor
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-018-2507-0

Purpose To investigate the factors associated with hospital readmission (HR) after retrograde intrarenal surgery (RIRS) among renal stone patients. Methods The study included patients who underwent RIRS from June 2011 to December 2017. Patients who were readmitted due to surgery-related complications were evaluated retrospectively. Patient demographics including age, medical comorbidity, body mass indices, ASA score, perioperative parameters and stone factors were compared with total cohorts. HR was defined as visits to the Emergency Room or unplanned admission within 30 days after discharge. The factors affecting HR rates were analyzed using uni- and multi-variate analyses. Results A total of 572 patients were enrolled into the study. The mean age was 57.6 ± 14.1 years and the mean stone diameter was 13.4 ± 6.2 mm. The mean complication rate was 6.1% and the median hospitalization time was 2.1 ± 3.4 days. HR occurred in 20 patients (3.5%). Compared to non-admission patients, readmitted patients had a higher rate of bilateral RIRS (20.0% vs 12.2%, p  = 0.035), number of stones (4.65 vs 2.2, p  = 0.041) and higher stone complexity score (4.15 vs 2.11, p  = 0.003). Multivariate analysis showed bilateral RIRS (OR 1.091, p  = 0.031) and stone complexity (OR 1.405, p  = 0.003) were significant factors to predict re-admission after RIRS. Conclusion Patients with complex renal stones or those who underwent bilateral RIRS were more likely to have a higher rate of re-admission. Proper perioperative management to prevent complications should be planned based on these predictive factors.