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医疗保健的障碍:非英语患者和老年患者更有可能留存输尿管支架。

Barriers to Healthcare: Non-English Speaking and Elderly Patients More Likely to Have Retained Ureteral Stents.

作者信息

Kothari Pankti, Du Chris, Aalami Harandi Arshia, Hwang Kuemin, Griffith Spencer, Kim Jason

机构信息

Department of Urology, Stony Brook University Medical Center, Stony Brook, NY.

Department of Urology, Stony Brook University Medical Center, Stony Brook, NY.

出版信息

Urology. 2024 Jan;183:46-49. doi: 10.1016/j.urology.2023.10.034. Epub 2023 Nov 24.

Abstract

OBJECTIVE

To identify factors for retained ureteral stents in our institution of patients receiving de novo ureteral stents. Ureteral stent placement, a commonly performed urologic procedure, is a temporary measure and requires timely removal. Retained ureteral stents may result in significant morbidities and need for additional procedures.

MATERIALS AND METHODS

We queried for all de novo ureteral stents indicated for calculi at our institution between July 2019-June 2021. Retained ureteral stents were defined as stents that remained indwelling for a period greater than 90days. Patients with metallic stents, stents on strings, pediatric patients, and planned therapy outside 90days were excluded. Patient demographic information including gender, race, age, insurance status, non-English speaking status as well as clinical data including location of presentation and indication were collected. Characteristics of patients with retained stents were compared to those without.

RESULTS

Four hundred fifty-seven de novo stent patients meeting study criteria were identified, of which 61 (13%) patients had retained stents. The median duration of retention was 24days +/- 32days (IQR). Patients with retained stents were older than those with stents removed within 90days (62.1 vs 57.2years, P = .03). Retained stents were more common among non-English-speaking patients (13% vs 5%, P = .012).

CONCLUSION

Stent retention was found to be associated with non-English speaking status and older age. Healthcare barriers in language and age may lead to increased morbidity due to stent retention.

摘要

目的

确定在我院接受初次输尿管支架置入术的患者中输尿管支架滞留的相关因素。输尿管支架置入术是一种常见的泌尿外科手术,是一种临时措施,需要及时取出。输尿管支架滞留可能导致严重的发病率增加,并需要额外的手术。

材料与方法

我们查询了2019年7月至2021年6月期间在我院因结石而置入的所有初次输尿管支架。输尿管支架滞留定义为支架留置时间超过90天。排除使用金属支架、带线支架的患者、儿科患者以及计划在90天以上进行治疗的患者。收集患者的人口统计学信息,包括性别、种族、年龄、保险状况、非英语使用状况,以及临床数据,包括就诊部位和适应症。将有支架滞留的患者特征与无支架滞留的患者进行比较。

结果

确定了457例符合研究标准的初次置入支架患者,其中61例(13%)患者出现支架滞留。滞留的中位时间为24天±32天(四分位间距)。有支架滞留的患者比在90天内取出支架的患者年龄更大(62.1岁对57.2岁,P = 0.03)。支架滞留在非英语患者中更为常见(13%对5%,P = 0.012)。

结论

发现支架滞留与非英语使用状况和年龄较大有关。语言和年龄方面的医疗保健障碍可能会因支架滞留而导致发病率增加。

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