The Risk Factors of Unplanned Hospital Readmission Following Percutaneous Nephrolithotomy

Abstract

Objective: Percutaneous nephrolithotomy (PNL) is currently recommended as the first treatment option for complex kidney stones larger than 2 cm. Although it is a safe and effective treatment, emergency room admissions and hospitalisations occur because of PNL complications. This study aimed to examine patient-related independent risk factors that may cause unplanned hospital readmission after PNL. Methods: Data of patients who were admitted to our clinic due to upper urinary system calculi and underwent conventional PNL operation between January 2015 and December 2019 were evaluated retrospectively. Hospital readmission was defined as unscheduled rehospitalisation within 30 days after discharge. The study cohort was divided into two groups: the readmission (group A) and non-readmission groups (group B). Post-operative complication scoring was performed according to the Clavien-Dindo classification. Multivariate logistic regression analysis was used to evaluate independent prognostic risk factors on readmission after PNL. Results: A total of 390 patients were included in our study. Of patients, 24 (6.1%) were readmitted to our clinic in the post-operative period. Gender, age, body mass index and stone volume were statistically similar between the groups. Based on multivariate analysis, the presence of Clavien 3a and 3b complications, post-operative blood transfusion, presence of preoperative hydronephrosis, American Society of Anaesthesiologist score and low stone density (<859 Hounsfield units) were determined as significant independent risk factors for readmission. Conclusion: Determination of preoperative risk factors will reduce hospital readmissions rates, thus reducing the potential burden on the health system and increasing patient comfort.