Immediate Unplanned Hospital Admission After Outpatient Ureteroscopy for Stone Disease
Immediate Unplanned Hospital Admission After Outpatient Ureteroscopy for Stone Disease
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DOI：
10.1016/j.juro.2011.01.081
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Wolf, J. Stuart, Jr.
中科院分区：
文献类型：
--
作者：
Tan, Hung-Jui;Strope, Seth A.;Wolf, J. Stuart, Jr.
目的：医疗保险最近改变了输尿管镜检查的报销，鼓励迁移到门诊手术中心。据我们所知，目前尚不清楚是否存在立即非计划性住院的风险，这可能会阻碍在门诊手术中心进行输尿管镜检查。我们确定了立即计划外住院率，确定与入院相关的因素，并制定了一个危险分层工具，以协助门诊输尿管镜检查的位置选择材料和方法：我们回顾性分析了1998年至2008年在我们的机构进行的1,798个连续的门诊输尿管镜手术治疗尿路结石的记录。需要立即住院的患者按提供者、性别和日期与不需要住院的对照组进行1至3匹配。通过双变量和多变量logistic回归分析，评估患者人口统计学资料、合并症、结石病史和结石负担以及手术技术对入院的影响。一个评分系统的开发和估计的入院率calculated.Results：有70立即计划外入院（3.9%）。根据多因素分析，与非计划性入院相关的因素是任何与结石相关的既往入院（p
Purpose: Medicare recently changed reimbursement for ureteroscopy, encouraging migration to ambulatory surgical centers. To our knowledge the risk of immediate unplanned hospital admission, which may discourage ureteroscopy at ambulatory surgical centers, is unknown. We determined the rate of immediate unplanned hospital admission, identified factors associated with admission and developed a risk stratification tool to assist with location selection for outpatient ureteroscopy.Materials and Methods: We retrospectively reviewed the records of 1,798 consecutive outpatient ureteroscopic procedures for urolithiasis performed from 1998 to 2008 at our institution. Patients requiring immediate hospital admission were matched 1 to 3 by provider, gender and date with controls who did not require admission. Patient demographics, comorbid conditions, stone history and burden, and operative technique were assessed for impact on admission by bivariate and multivariate logistic regression. A scoring system was developed and estimated admission rates were calculated.Results: There were 70 immediate unplanned admissions (3.9%). Based on multivariate analysis the factors associated with unplanned admission were any previous admission related to stones (p