Percutaneous nephrolithotomy in England: practice and outcomes described in the Hospital Episode Statistics database. (21st November 2013)

• Record Type: Journal Article
• Authors: Armitage, James N.; Withington, John; van der, Jan; Cromwell, David A.; Glass, Jonathan; Finch, William G.; Irving, Stuart O.; Burgess, Neil A.
• Is Part Of: BJU international. Volume 113:Number 5(2014:May)
• Page Start: 777
• Page End: 782
• Publication Date: 2013-11-21
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12373
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12373-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12373-list-0001" list-type="bullet"> <list-item> <p>To investigate the postoperative outcomes of percutaneous nephrolithotomy (PCNL) in English National Health Service (NHS) hospitals.</p> </list-item> </list> </p> </sec> <sec id="bju12373-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju12373-list-0002" list-type="bullet"> <list-item> <p>We extracted records from the Hospital Episode Statistics (HES) database for all patients undergoing PCNL between March 2006 and January 2011 in English NHS hospitals.</p> </list-item> <list-item> <p>Outcome measures were haemorrhage, infection within the index admission, and rates of emergency readmission and in‐hospital mortality within 30 days of surgery.</p> </list-item> </list> </p> </sec> <sec id="bju12373-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12373-list-0003" list-type="bullet"> <list-item> <p>A total of 5750 index PCNL procedures were performed in 165 hospitals.</p> </list-item> <list-item> <p>During the index admission, haemorrhage was recorded in 81 patients (1.4%), 192 patients (3.8%) had a urinary tract infection (UTI), 95 patients (1.7%) had fever, and 41 patients (0.7%) had sepsis.</p> </list-item> <list-item> <p>There were 595 emergency readmissions in 518 patients (9.0%). Reasons for readmission were varied: 70 (1.2%) with UTI, 15 (0.3%) sepsis, 73 (1.3%) haematuria, 25 (0.4%) haemorrhage, and 25 (0.4%) acute urinary retention.</p> </list-item> <list-item> <p>There were 13 (0.2%) in‐hospital deaths within 30 days of surgery.</p> </list-item> </list> </p> </sec> <sec id="bju12373-sec-0004" sec-type="section"> <title>Conclusions</title> <p> <list id="bju12373-list-0004" list-type="bullet"> <list-item> <p>Haemorrhage and infection represent relatively common and potentially severe complications of PCNL.</p> </list-item> <list-item> <p>Mortality is extremely rare after PCNL (about one in 400 procedures overall) but almost one in 10 patients have an unplanned hospital readmission within 30 days of surgery.</p> </list-item> <list-item> <p>Complications of PCNL may be under‐reported in the HES database and need to be corroborated using other data sources.</p> </list-item> </list> </p> </sec> </abstract>