Urolithiasis

, Volume 46, Issue 3, pp 291–296 | Cite as

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

  • Ahmed R. EL-Nahas
  • Diaa-Eldin Taha
  • Mohamed M. Elsaadany
  • Mohamed H. Zahran
  • Mohamed Hassan
  • Khaled Z. Sheir
Original Paper

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.

Keywords

Extracorporeal shock wave lithotripsy SWL Renal stones Complications Hospital admission 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interests.

Ethical approval

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.

References

  1. 1.
    Assimos D, Krambeck A, Miller NL et al (2016) Surgical management of stones: American urological association/endourological society guideline, part II. J Urol 196:1161–1169CrossRefPubMedGoogle Scholar
  2. 2.
    Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69:475–482CrossRefPubMedGoogle Scholar
  3. 3.
    Skolarikos A, Alivizatos G, de la Rosette J (2006) Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol 50:981–990CrossRefPubMedGoogle Scholar
  4. 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 42:247–253CrossRefPubMedGoogle Scholar
  5. 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 26:1478–1482CrossRefPubMedGoogle Scholar
  6. 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 167:12349–12442CrossRefGoogle Scholar
  7. 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 37:477–482CrossRefPubMedGoogle Scholar
  8. 8.
    Duvdevani M, Lorber G, Gofrit ON et al (2010) Fever after shockwave lithotripsy—risk factors and indications for prophylactic antimicrobial treatment. J Endourol 24:277–281CrossRefPubMedGoogle Scholar
  9. 9.
    Schmid M, Chiang HA, Sood A et al (2016) Causes of hospital readmissions after urologic cancer surgery. Urol Oncol 34:236 e1–e11PubMedGoogle Scholar
  10. 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 115:94–100CrossRefPubMedGoogle Scholar
  11. 11.
    Rambachan A, Matulewicz RS, Pilecki M, Kim JY, Kundu SD (2014) Predictors of readmission following outpatient urological surgery. J Urol 192:183–188CrossRefPubMedGoogle Scholar
  12. 12.
    Tepeler A, Karatag T, Tok A et al (2016) Factors affecting hospital readmission and rehospitalization following percutaneous nephrolithotomy. World J Urol 34:69–73CrossRefPubMedGoogle Scholar
  13. 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 29:410–414CrossRefPubMedGoogle Scholar
  14. 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 155:769–775CrossRefPubMedGoogle Scholar
  15. 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 240:205–213CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Joynt KE, Jha AK (2012) Thirty-day readmissions—truth and consequences. N Engl J Med 366:1366–1369CrossRefPubMedGoogle Scholar
  17. 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 189:59–65CrossRefPubMedGoogle Scholar
  18. 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 38:135–142CrossRefPubMedGoogle Scholar
  19. 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 176:2059–2062CrossRefPubMedGoogle Scholar
  20. 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 84:618–621CrossRefPubMedGoogle Scholar
  21. 21.
    Lee HY, Yang YH, Shen JT et al (2013) Risk factors survey for extracorporeal shockwave lithotripsy-induced renal hematoma. J Endourol 27:763–767CrossRefPubMedGoogle Scholar
  22. 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 172:2271–2274CrossRefPubMedGoogle Scholar
  23. 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 69:267–273CrossRefPubMedGoogle Scholar
  24. 24.
    Krishnamurthi V, Streem SB (1995) Long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy induced perirenal hematomas. J Urol 154:1673–1675CrossRefPubMedGoogle Scholar
  25. 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 30:1233–1238CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Ahmed R. EL-Nahas
    • 1
  • Diaa-Eldin Taha
    • 1
  • Mohamed M. Elsaadany
    • 1
  • Mohamed H. Zahran
    • 1
  • Mohamed Hassan
    • 1
  • Khaled Z. Sheir
    • 1
  1. 1.Urology Department, Urology and Nephrology CenterMansoura UniversityMansouraEgypt

Personalised recommendations