Frequency and timing of emergency department visits and hospital admissions in stented patients following common stone procedures.

Abstract

Emergency department (ED) visits and hospital admissions (HA) following urologic procedures are a concern for payors, providers, and patients. We seek to quantify ED visits and HA after urologic stone procedures. This is a retrospective cohort study using claims data from the IBM MarketScan Commercial and Medicare Supplement database. Adults with a urologic stone diagnosis and no history of stone procedure in prior 12months who underwent stone procedures with ureteral stent codes between 2012 and 2017 were included. All-cause vs genitourinary (GU)-related ED visits and HA were evaluated during 30, 60, 90, and 120-day periods following the index urologic stone procedure. 88,047 patients were included in the analytic cohort. For inpatients, rate of all-cause vs GU-related ED visits was 10% vs 9% at 30days and 19% vs 15% at 120days. For outpatients, rate of all-cause vs GU-related ED visits was 9% vs 8% at 30days and 15% vs 12% at 120days. A similar trend was found when examining HA. Younger patients (18-44years old) had higher rates of all-cause ED visits following inpatient index stone procedure (13% vs 10% at 30days, p ≤ 0.0001). Twenty percent of patients have an ED visit or HA up to 120days after having a stone procedure with most returning with GU-related complaint. Younger patients had the greatest burden among the study cohort. Further studies need to determine causation of these unplanned visits to guide appropriate intervention.