Mittakanti Harsha R, Conti Simon L, Pao Alan C, Chertow Glenn M, Liao Joseph C, Leppert John T, Elliott Christopher S
Department of Urology, Stanford University School of Medicine, Stanford, CA.
Department of Urology, Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Urology. 2018 Jul;117:44-49. doi: 10.1016/j.urology.2018.03.019. Epub 2018 Mar 27.
To evaluate unplanned medical visits within the early postoperative period after ureteroscopy in patients with and without ureteral stent placement.
We identified all ureteroscopic procedures for urinary stone disease in the California Office of Statewide Health Planning and Development database from 2010 to 2012. The primary outcome was any emergency department visit or inpatient hospital admission in the first 7 days following ureteroscopy. Patients were subcategorized by type of ureteroscopy (ie, laser lithotripsy vs basket retrieval) and were analyzed for significant differences between stented and unstented patients. Multivariable logistic regression was performed to determine if ureteral stent placement was independently associated with unplanned visits.
Our analytic cohort included 16,060 patients undergoing 17,716 ureteroscopy procedures. A ureteral stent was placed in 86.2% of patients undergoing laser lithotripsy and in 70.5% of patients receiving basket retrieval. In the 7 days following ureteroscopy, 6.6% of patients were seen in the emergency department and 2.2% of patients were admitted to a hospital. In a fully adjusted model, the utilization of a ureteral stent was not associated with emergency department visits or inpatient admissions.
Ureteral stent placement during ureteroscopy is not associated with an increased odds of emergency department visits and inpatient admissions in the early postoperative period.
评估输尿管镜检查术后早期有或无输尿管支架置入患者的非计划性医疗就诊情况。
我们在加利福尼亚州全州卫生规划与发展办公室数据库中识别出2010年至2012年期间所有因尿路结石疾病进行的输尿管镜检查手术。主要结局是输尿管镜检查术后前7天内的任何急诊就诊或住院情况。患者按输尿管镜检查类型（即激光碎石术与取石篮取石术）进行亚分类，并分析置入支架和未置入支架患者之间的显著差异。进行多变量逻辑回归以确定输尿管支架置入是否与非计划性就诊独立相关。
我们的分析队列包括16060例接受17716次输尿管镜检查手术的患者。接受激光碎石术的患者中有86.2%置入了输尿管支架，接受取石篮取石术的患者中有70.5%置入了输尿管支架。在输尿管镜检查术后7天内，6.6%的患者前往急诊就诊，2.2%的患者住院。在完全调整模型中，输尿管支架的使用与急诊就诊或住院无关。
输尿管镜检查期间置入输尿管支架与术后早期急诊就诊和住院几率增加无关。
