PD34-10 IMPACT OF SEPSIS ON ADMISSIONS, RE ADMISSIONS AND MORTALITY FOLLOWING URETEROSCOPY

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD34-10 IMPACT OF SEPSIS ON ADMISSIONS, RE ADMISSIONS AND MORTALITY FOLLOWING URETEROSCOPY Naeem Bhojani, Brian Eisner, Rutugandha Paranjpe, Benjamin Cutone, Manoj Monga, and Ben H. Chew Naeem BhojaniNaeem Bhojani More articles by this author , Brian EisnerBrian Eisner More articles by this author , Rutugandha ParanjpeRutugandha Paranjpe More articles by this author , Benjamin CutoneBenjamin Cutone More articles by this author , Manoj MongaManoj Monga More articles by this author , and Ben H. ChewBen H. Chew More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003327.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Post-ureteroscopy sepsis is a morbid condition that requires significant healthcare utilization. We investigated all-cause inpatient mortality, rates of intensive care unit (ICU) and inpatient admissions and readmissions. We also examine the yearly trends in sepsis and inpatient mortality in patients undergoing ureteroscopy (URS) in the United States (US). METHODS: Retrospective analyses were conducted using the IBM MarketScan Database to identify patients ≥18 years who underwent URS. Three cohorts were analyzed: non-sepsis (control), non-severe sepsis, and severe sepsis (sepsis + organ dysfunction). All-cause inpatient mortality and healthcare utilization including ICU admissions, inpatient admissions and readmissions were reported. Annual trends for sepsis events and inpatient mortality post-URS were examined from 2015-2019. RESULTS: 109,496 URS patients were identified. 5.6% developed sepsis within 30 days of URS. Of the 5.6%, 4.1% developed non-severe sepsis and 1.5% developed severe sepsis. The 30-day all-cause inpatient mortality for the non-sepsis, non-severe sepsis and severe sepsis cohorts was 0.03%, 0.27% and 2.5%, respectively (p<0.001). Severe sepsis substantially increased the risk of 30-day all-cause inpatient mortality compared to patients who did not develop sepsis (HR: 49.5; 95% CI: 28.9-84.7; p<0.001). ICU admission rates were 1.5%, 19.8% 52.4% for the non-sepsis, non-severe sepsis, and severe sepsis cohorts, respectively (p<0.001). Inpatient admissions were 18.3%, 74.9%, and 76.9% (p<0.001), while readmissions were 7.1%, 12.0%, and 15.9% (p<0.001), for the non-sepsis, non-severe sepsis, and severe sepsis cohorts, respectively. From 2015 to 2019, the annual prevalence of sepsis post URS increased significantly yearly from 4.7%, 5.1%, 5.7%, 6.0%, to 6.6% (p<0.001), however the rate of inpatient mortality remained stable (Figure 1). CONCLUSIONS: Sepsis post-URS significantly increases the risk of 30-day all cause inpatient mortality and leads to a significant increase in hospital admissions, ICU admissions, and readmissions. Over the 5-year study period, the prevalence of sepsis post-URS increased by 40%. Urologists should be aware of the increasing prevalence of this potentially deadly post-operative complication. Source of Funding: Boston Scientific © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e924 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naeem Bhojani More articles by this author Brian Eisner More articles by this author Rutugandha Paranjpe More articles by this author Benjamin Cutone More articles by this author Manoj Monga More articles by this author Ben H. Chew More articles by this author Expand All Advertisement PDF downloadLoading ...