Department of Urology, Namik Kemal University Faculty of Medicine, Tekirdag, Turkey.
Gaziosmanpaşa Training and Research Hospital Clinic of Urology, Istanbul, Turkey.
J Endourol. 2022 Jan;36(1):56-64. doi: 10.1089/end.2021.0327. Epub 2021 Dec 9.
Retrograde intrarenal surgery (RIRS) is a safe and effective treatment option for upper urinary tract stones smaller than 2 cm. Although several studies have documented perioperative and postoperative complications related to RIRS, there exists limited data regarding the readmission and rehospitalization of patients after RIRS. The aims of the study were to document the rates of readmission and rehospitalization after RIRS and to determine the predictive factors for readmission and rehospitalization. In this study, we retrospectively analyzed patients who underwent RIRS for the treatment of renal stone disease and were unexpectedly readmitted to the hospital within 30 days after discharge. The hospital admission systems were used to determine readmissions and rehospitalizations. Readmission and rehospitalization rates, causes, and treatment procedures were evaluated. Univariate and multivariate analyses of clinicodemographic properties were performed to evaluate possible predictive factors for readmission and rehospitalization after RIRS. A total of 1036 patients were included in the study. Of these patients, 103 (9.9%) were readmitted to the hospital. Among these readmissions, 35 patients (33.9%) were rehospitalized and 14 (13.6%) underwent surgical intervention. The most common reasons for readmission were renal colic and fever. The presence of preoperative pyuria (odds ratio [OR] 1.86), stone volume (OR 1.54), postoperative complications (OR 3.66), and stone-free status (OR 0.46) were predictive factors for readmission, whereas hospitalization time (OR 1.32), postoperative complications (OR 9.70), and stone-free status (OR 0.06) were predictive factors for rehospitalization after RIRS. Nearly 10% of patients who underwent RIRS were readmitted to the hospital within the first month after discharge, and some were rehospitalized. Preoperative pyuria, high stone volume, presence of postoperative complications, and low stone-free status predicted this readmission and rehospitalization. Clinicians must recognize these predictive factors and inform their patients about this possibility.
经皮肾镜取石术(RIRS)是一种安全有效的治疗上尿路结石的方法,结石直径小于 2cm。尽管有几项研究记录了与 RIRS 相关的围手术期和术后并发症,但关于 RIRS 后患者再入院和再住院的数据有限。本研究旨在记录 RIRS 后再入院和再住院的发生率,并确定再入院和再住院的预测因素。在这项研究中,我们回顾性分析了因肾结石病接受 RIRS 治疗并在出院后 30 天内意外再次入院的患者。使用医院入院系统确定再入院和再住院。评估了再入院和再住院的发生率、原因和治疗程序。对临床病理特征进行单因素和多因素分析,以评估 RIRS 后再入院和再住院的可能预测因素。共有 1036 例患者纳入本研究。其中 103 例(9.9%)患者再次入院。在这些再入院患者中,35 例(33.9%)患者再次住院,14 例(13.6%)患者接受了手术干预。再入院的最常见原因是肾绞痛和发热。术前脓尿(优势比[OR]1.86)、结石体积(OR 1.54)、术后并发症(OR 3.66)和结石清除状态(OR 0.46)是再入院的预测因素,而住院时间(OR 1.32)、术后并发症(OR 9.70)和结石清除状态(OR 0.06)是 RIRS 后再住院的预测因素。接受 RIRS 的患者中有近 10%在出院后第一个月内再次入院,其中一些需要再次住院。术前脓尿、大结石体积、术后并发症和低结石清除状态预测了这种再入院和再住院的发生。临床医生必须认识到这些预测因素,并将这种可能性告知患者。