Which factors affect the hospital re-admission and re-hospitalization after flexible ureterorenoscopy for kidney stone?

Abstract

To investigate patient- and procedure-related factors associated with hospital re-admission (HR) and re-hospitalization following flexible ureteroscopy (f-URS). The records of patients who underwent f-URS for renal stones in two reference centers between 2011 and 2015 were examined retrospectively. Patients who were re-admitted to the hospital or re-hospitalized for any reason within 30days after hospital discharge related to the f-URS procedure were evaluated. The patient- and procedure-related factors affecting the re-admission and re-hospitalization rates were revealed using backward stepwise multiple binary logistic regression analysis. The study included 647 patients with a mean age of 46.1±13.7years. The mean BMI was 27.3±4.6kg/m(2), and the median ASA score was 1.85. The mean stone diameter was 14.2±5.3mm. The mean operation and fluoroscopy times were 50.2±16.9min and 43.1±37.6s, respectively. The mean hospitalization time was 1.42±0.84days, and the complication rate was 12.8% (83/647). Overall, 523 (80.3%) patients became stone-free, while residual fragments <4mm were detected in 73 (11.3%) patients. The procedure failed in 7.9% of the cases. While 82 (12.7%) patients were re-admitted, 31 (4.8%) patients were re-hospitalized for further treatment. Stone-free status was an independent predictor of HR, while the stone-free status, hospitalization time, and postoperative complications all predicted re-hospitalization. We found that inability to achieve stone-free status predicted HR and re-hospitalization, while postoperative complication and prolonged hospitalization also predicted re-hospitalization.