You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal III1 Apr 20121825 OPERATION TIME AND POSTOPERATIVE SEVERE ADVERSE EVENTS IN URETERORENOSCOPIC LITHOTORIPSY Toru Sugihara, Hideo Yasunaga, Hiromasa Horiguchi, Hiroaki Nishimatsu, Akira Ishikawa, Haruki Kume, Shinya Matsuda, Kiyohide Fushimi, and Yukio Homma Toru SugiharaToru Sugihara Iwata, Japan More articles by this author , Hideo YasunagaHideo Yasunaga Tokyo, Japan More articles by this author , Hiromasa HoriguchiHiromasa Horiguchi Tokyo, Japan More articles by this author , Hiroaki NishimatsuHiroaki Nishimatsu Tokyo, Japan More articles by this author , Akira IshikawaAkira Ishikawa Tokyo, Japan More articles by this author , Haruki KumeHaruki Kume Tokyo, Japan More articles by this author , Shinya MatsudaShinya Matsuda Tokyo, Japan More articles by this author , Kiyohide FushimiKiyohide Fushimi Tokyo, Japan More articles by this author , and Yukio HommaYukio Homma Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1913AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To our knowledge, there is no quantitative analysis to show the relation between operation time of ureterorenoscopic lithotripsy (URS) and its postoperative severe adverse events (sAE) such as urosepsis. In this study, we analyzed this correlation using the Japanese nationwide administrative claims database; the Diagnosis Procedure Combination (DPC) database. METHODS The DPC database contains information on diagnoses, medical resources/procedures, and discharge status. The database covered more than 40% (about 2.8 million in about 850 hospitals per year) of all acute care inpatient hospitalizations in Japan. As study samples, we extracted cases with a Japanese operation code K781 (URS for urolithiasis) during 2006-2010. In order to exclude cases whose preoperative status is emergency or irregular, ambulance users and delayed-operation cases (URS date > 2 business days since admission) were excluded. Adjusting variables are age, sex, Charlson comorbidity index and operative time. SAE were defined as i) morality; ii) medications comprised of anti-DIC drugs, gamma-globulin and catecholamine; and iii) interventions including an intensive care unit use, central intravenous catheterization, mechanical ventilation, dialysis and cardiac pumping support. Multivariate logistic regression analysis on sAE was performed. RESULTS Among 7323 URS cases, 179 sAE (2.4%) including 4 morality were detected. SAE incidences of operative time<60 minutes, 60-120, >120 were 1.5%, 2.4% and 4.5%, respectively. (Figure) Multivariate regression analysis on sAE resulted in as follow: female (odds ratio (OR), 1.64; p<0.01), age (p=0.37), Charlson comorbidity index (one point increment, OR, 1.26; p<0.01), operative time (30 min increment, OR 1.44; p<0.01). CONCLUSIONS SAE incidence increases in proportion to operative time. To set a certain limitation for URS operation time would be relevant for patient safety. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e737 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toru Sugihara Iwata, Japan More articles by this author Hideo Yasunaga Tokyo, Japan More articles by this author Hiromasa Horiguchi Tokyo, Japan More articles by this author Hiroaki Nishimatsu Tokyo, Japan More articles by this author Akira Ishikawa Tokyo, Japan More articles by this author Haruki Kume Tokyo, Japan More articles by this author Shinya Matsuda Tokyo, Japan More articles by this author Kiyohide Fushimi Tokyo, Japan More articles by this author Yukio Homma Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...