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Hospital admission for treatment of complications after extracorporeal shock wave lithotripsy for renal stones: a study of risk factors

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Abstract

The objective of this study was to determine risk factors of hospital admission for treatment of complications after extracorporeal shock wave lithotripsy (SWL). The electronic files and images of all patients who underwent SWL for treatment of renal stones between January 2011 and December 2015 were retrospectively reviewed. All patients underwent SWL with the same electromagnetic lithotripter (Dornier Lithotripot S). The data of those who needed hospital admission for treatment of complications within 30 days after SWL were compared with patients who did not require hospital admission. Compared data included patients’ demographics (age, gender, BMI, ASA score, and pre-SWL stenting), renal characters (side, hydronephrosis, and solitary kidney), and stone characters (site, length, density, and previous treatment). Univariate and multivariate statistical analyses were used to identify risk factors. The study included 1179 patients. Complications that required hospital admission were observed in 108 patients (9.2%). They included obstructing steinstrasse in 91 (7.7%), peri-renal hematoma in 3 (0.25%), and fever (>38.0 °C) in 14 (1.2%). Independent risk factors on multivariate analysis were solitary kidney (OR 2.855, P = 0.017), pre-SWL stenting (RR 2.03, P = 0.044), ASA II (OR 1.965, P = 0.007), hydronephrosis (RR 1.639, P = 0.024), and stone length (RR 1.083, P < 0.001). Patients with medical co-morbidities, pre-SWL ureteral stents, large stones and those with obstructed and/or solitary renal unit are more liable to post-SWL complications that need hospital admission. The probability of hospital admission has to be explained to patients with these risk factors.

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References

  1. Assimos D, Krambeck A, Miller NL et al (2016) Surgical management of stones: American urological association/endourological society guideline, part II. J Urol 196:1161–1169

    Article  PubMed  Google Scholar 

  2. Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482

    Article  PubMed  Google Scholar 

  3. Skolarikos A, Alivizatos G, de la Rosette J (2006) Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol 50:981–990

    Article  PubMed  Google Scholar 

  4. Schnabel MJ, Gierth M, Chaussy CG, Dotzer K, Burger M, Fritsche HM (2014) Incidence and risk factors of renal hematoma: a prospective study of 1300 SWL treatments. Urolithiasis 42:247–253

    Article  PubMed  CAS  Google Scholar 

  5. Razvi H, Fuller A, Nott L et al (2012) Risk factors for perinephric hematoma formation after shockwave lithotripsy: a matched case-control analysis. J Endourol 26:1478–1482

    Article  PubMed  Google Scholar 

  6. Madbouly K, Sheir KZ, Elsobky E, Eraky I, Kenawy M (2002) Risk factors for the formation of steinstrasse after extracorporeal shock wave lithotripsy: a statistical model. J Urol 167:12349–12442

    Article  Google Scholar 

  7. Lucio J 2nd, Korkes F, Lopes-Neto AC et al (2011) Steinstrasse predictive factors and outcomes after extracorporeal shockwave lithotripsy. Int Braz J Urol 37:477–482

    Article  PubMed  Google Scholar 

  8. Duvdevani M, Lorber G, Gofrit ON et al (2010) Fever after shockwave lithotripsy—risk factors and indications for prophylactic antimicrobial treatment. J Endourol 24:277–281

    Article  PubMed  Google Scholar 

  9. Schmid M, Chiang HA, Sood A et al (2016) Causes of hospital readmissions after urologic cancer surgery. Urol Oncol 34:236 e1–e11

    PubMed  Google Scholar 

  10. Harraz AM, Osman Y, El-Halwagy S et al (2015) Risk factors of hospital readmission after radical cystectomy and urinary diversion: analysis of a large contemporary series. BJU Int 115:94–100

    Article  PubMed  Google Scholar 

  11. Rambachan A, Matulewicz RS, Pilecki M, Kim JY, Kundu SD (2014) Predictors of readmission following outpatient urological surgery. J Urol 192:183–188

    Article  PubMed  Google Scholar 

  12. Tepeler A, Karatag T, Tok A et al (2016) Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy. World J Urol 34:69–73

    Article  PubMed  Google Scholar 

  13. Beiko D, Elkoushy MA, Kokorovic A, Roberts G, Robb S, Andonian S (2015) Ambulatory percutaneous nephrolithotomy: what is the rate of readmission? J Endourol 29:410–414

    Article  PubMed  Google Scholar 

  14. Scales CD Jr, Saigal CS, Hanley JM et al (2014) The impact of unplanned postprocedure visits in the management of patients with urinary stones. Surgery 155:769–775

    Article  PubMed  Google Scholar 

  15. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of a 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  16. Joynt KE, Jha AK (2012) Thirty-day readmissions—truth and consequences. N Engl J Med 366:1366–1369

    Article  PubMed  CAS  Google Scholar 

  17. Jacobs BL, Zhang Y, Tan HJ, Ye Z, Skolarus TA, Hollenbeck BK (2013) Hospitalization trends after prostate and bladder surgery: implications of potential payment reforms. J Urol 189:59–65

    Article  PubMed  Google Scholar 

  18. Salem S, Mehrsai A, Zartab H, Shahdadi N, Pourmand G (2010) Complications and outcomes following extracorporeal shock wave lithotripsy: a prospective study of 3241 patients. Urol Res 38:135–142

    Article  PubMed  Google Scholar 

  19. El-Assmy A, El-Nahas AR, Sheir KZ (2006) Is pre-shock wave lithotripsy stenting necessary for ureteral stones with moderate or severe hydronephrosis? J Urol 176:2059–2062

    Article  PubMed  Google Scholar 

  20. Al-Awadi KA, Abdul Halim H, Kehinde EO, Al-Tawheed A (1999) Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management. BJU Int 84:618–621

    Article  PubMed  CAS  Google Scholar 

  21. Lee HY, Yang YH, Shen JT et al (2013) Risk factors survey for extracorporeal shockwave lithotripsy-induced renal hematoma. J Endourol 27:763–767

    Article  PubMed  Google Scholar 

  22. Dhar NB, Thornton J, Karafa MT, Streem SB (2004) A multivariate analysis of risk factors associated with subcapsular hematoma formation following electromagnetic shock wave lithotripsy. J Urol 172:2271–2274

    Article  PubMed  Google Scholar 

  23. Skuginna V, Nguyen DP, Seiler R, Kiss B, Thalmann GN, Roth B (2016) Does stepwise voltage ramping protect the kidney from injury during extracorporeal shockwave lithotripsy? Results of a prospective randomized trial. Eur Urol 69:267–273

    Article  PubMed  Google Scholar 

  24. Krishnamurthi V, Streem SB (1995) Long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy induced perirenal hematomas. J Urol 154:1673–1675

    Article  PubMed  CAS  Google Scholar 

  25. Alexander CE, Gowland S, Cadwallader J, Hopkins D, Reynard JM, Turney BW (2016) Routine antibiotic prophylaxis is not required for patients undergoing shockwave lithotripsy: outcomes from a national shockwave lithotripsy database in New Zealand. J Endourol 30:1233–1238

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    Ahmed R. EL-Nahas, Diaa-Eldin Taha, Mohamed M. Elsaadany, Mohamed H. Zahran, Mohamed Hassan & Khaled Z. Sheir

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  1. Ahmed R. EL-Nahas
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  2. Diaa-Eldin Taha
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  3. Mohamed M. Elsaadany
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  4. Mohamed H. Zahran
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  5. Mohamed Hassan
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  6. Khaled Z. Sheir
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Correspondence to Ahmed R. EL-Nahas.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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EL-Nahas, A.R., Taha, DE., Elsaadany, M.M. et al. Hospital admission for treatment of complications after extracorporeal shock wave lithotripsy for renal stones: a study of risk factors. Urolithiasis 46, 291–296 (2018). https://doi.org/10.1007/s00240-017-0983-0

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  • DOI: https://doi.org/10.1007/s00240-017-0983-0

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