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

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A Letter to the Editor to this article was published on 16 November 2019

Abstract

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.

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Abbreviations

ESWL:

Extracorporeal shock wave lithotripsy

PCNL:

Percutaneous nephrolithotomy

RIRS:

Retrograde intrarenal surgery

SFR:

Stone-free rates

HR:

Hospital readmission

ER:

Emergency room

S-ReSc:

Seoul National University Renal Stone Complexity score

ASA:

American Society of Anesthesiologists

BMI:

Body mass index

OR:

Odds ratio

URS:

Ureteroscopy

UTI:

Urinary tract infection

References

  1. Türk C, Knoll T, Petrik A et al (2015) European Association of Urology, guidelines on urolithiasis. Eur Urol 69:468

    Article  Google Scholar 

  2. Berardinelli F, Proietti S, Cindolo L et al (2016) A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone. Int Braz J Urol 42:479–486

    Article  Google Scholar 

  3. Bryniarski P, Paradysz A, Zyczkowski M et al (2012) A randomized controlled study to analyze the safety and efficacy of percutaneous nephrolithotripsy and retrograde intrarenal surgery in the management of renal stones more than 2 cm in diameter. J Endourol 26(1):52–57

    Article  Google Scholar 

  4. Kumar A, Vasudeva P, Nanda B et al (2015) A prospective randomized comparison between shockwave lithotripsy and flexible ureterorenoscopy for lower caliceal stones ≤ 2 cm: a single-center experience. J Endourol 29(5):575–579

    Article  Google Scholar 

  5. Oguz U, Resorlu B, Ozyuvali E et al (2014) Categorizing intraoperative complications of retrograde intrarenal surgery. Urol Int 92(2):164–168

    Article  Google Scholar 

  6. Scales CD Jr, Saigal CS, Hanley JM et al (2014) The impact of unplanned post procedure visits in the management of patients with urinary stones. Surgery 155(5):769–775

    Article  Google Scholar 

  7. Litwin MS, Saigal CS (eds) (2012) Urologic diseases in America. US department of health and human services, Public health service, National institutes of health, National institute of diabetes and digestive and kidney diseases. US Government Printing Office, Washington, DC, NIH Publication No. 12-7865

  8. Rambachan A, Matulewicz RS, Pilecki M et al (2014) Predictors of readmission following outpatient urological surgery. J Urol 192(1):183–188

    Article  Google Scholar 

  9. Armitage JN, Withington J, van der Meulen J et al (2014) Percutaneous nephrolithotomy in England: practice and outcomes described in the hospital episode statistics database. BJU Int 113(5):777–782

    Article  Google Scholar 

  10. Sfoungaristos S, Hidas G, Gofrit ON et al (2014) A novel model to predict the risk of readmission in patients with renal colic. J Endourol 28(8):1011–1015

    Article  Google Scholar 

  11. Beiko D, Elkoushy MA, Kokorovic A et al (2015) Ambulatory percutaneous nephrolithotomy: what is the rate of readmission? J Endourol 29(4):410–414

    Article  Google Scholar 

  12. Pais VM Jr, Smith RE, Stedina EA et al (2016) Does omission of ureteral stents increase risk of unplanned return visit? A systematic review and meta-analysis. J Urol 196(5):1458–1466

    Article  Google Scholar 

  13. Buldu I, Tepeler A, Karatag T et al (2016) Which factors affect the hospital re-admission and re-hospitalization after flexible ureterorenoscopy for kidney stone? World J Urol 34(9):1291–1295

    Article  Google Scholar 

  14. Bloom J, Matthews G, Phillips J (2016) Factors influencing readmission after elective ureteroscopy. J Urol 195(5):1487–1491

    Article  Google Scholar 

  15. Moses RA, Ghali FM, Pais VM Jr et al (2016) Unplanned hospital return for infection following ureteroscopy—can we identify modifiable risk factors? J Urol 195(4 Pt 1):931–936

    Article  Google Scholar 

  16. Kandasami SV, Mamoulakis C, El-Nahas AR et al (2014) CROES URS Global Study Group. Impact of case volume on outcomes of ureteroscopy for ureteral stones: the Clinical Research Office of the Endourological Society ureteroscopy global study. Eur Urol 66(6):1046–1051

    Article  Google Scholar 

  17. Jeong CW, Jung JW, Cha WH et al (2013) Seoul National University Renal Stone Complexity score for predicting stone-free rate after percutaneous nephrolithotomy. PLoS ONE 8:e65888

    Article  CAS  Google Scholar 

  18. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205

    Article  Google Scholar 

  19. Hesse A, Brandle E, Wilbert D et al (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 versus 2000. Eur Urol 44(6):709–713

    Article  CAS  Google Scholar 

  20. Scales CD Jr, Smith AC, Hanley JM et al (2012) Urologic diseases in America project. Prevalence of kidney stones in the United States. Eur Urol 62(1):160–165

    Article  Google Scholar 

  21. Dincel N, Resorlu B, Unsal A et al (2013) Are small residual stone fragments really insignificant in children? J Pediatr Surg 48(4):840–844

    Article  Google Scholar 

  22. Tepeler A, Karatag T, Tok A et al (2016) Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy. World J Urol 34:69

    Article  Google Scholar 

  23. Breda A, Angerri O (2014) Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol 24:179–183

    Article  Google Scholar 

  24. Sabnis RB, Ganesamoni R, Doshi A et al (2013) Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 112:355–361

    Article  Google Scholar 

  25. Giusti G, Proietti S, Peschechera R et al (2015) Sky is no limit for ureteroscopy: extending the indications and special circumstances. World J Urol 33:257–273

    Article  Google Scholar 

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Acknowledgements

This work was supported by Grant no. SNUBH-02-2016-015 from the SNUBH (Seoul National University Bundang Hospital) Research Fund and supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2014R1A1A2069658).

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Authors and Affiliations

  1. Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam, Gyeongi-do, 463-707, Korea

    Tae Jin Kim, In Jae Lee, Jung Keun Lee, Hak Min Lee, Sung Kyu Hong, Seok-Soo Byun & Jong Jin Oh

  2. Department of Urology, Seoul National University Hospital, Seoul, Korea

    Chang Wook Jeong

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  1. Tae Jin Kim
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  2. In Jae Lee
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  3. Jung Keun Lee
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  4. Hak Min Lee
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  5. Chang Wook Jeong
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  6. Sung Kyu Hong
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  7. Seok-Soo Byun
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  8. Jong Jin Oh
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Contributions

TJK, IJL, JJO: protocol development, data collection, data analysis, manuscript writing; TJK, IJL, HML, JKL: data collection; TJK, IJL: protocol development, data collection; JJO, CWJ, SKH, SSB: project development, protocol development, data collection, data analysis, manuscript editing.

Corresponding author

Correspondence to Jong Jin Oh.

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Conflict of interest

All authors have no conflict of interest with any institution or product.

Ethical approval

All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kim, T.J., Lee, I.J., Lee, J.K. et al. Analysis of factors affecting re-admission after retrograde intrarenal surgery for renal stone. World J Urol 37, 1205–1210 (2019). https://doi.org/10.1007/s00345-018-2507-0

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  • DOI: https://doi.org/10.1007/s00345-018-2507-0

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