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Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease.

Publication ,  Journal Article
Kurtzman, JT; Song, L; Ross, ME; Scales, CD; Chu, DI; Tasian, GE
Published in: J Urol
July 2018

PURPOSE: We determined the association between urology consultation and emergency department revisits for children with urinary stones. MATERIALS AND METHODS: This retrospective cohort study included patients 18 years old or younger who presented to an emergency department in South Carolina with a urinary stone from 1997 to 2015. The primary exposure was urology consultation during the index emergency department visit. The primary outcome was a stone related emergency department revisit occurring within 180 days of discharge from an index emergency department visit. Secondary outcomes included computerized tomography use, inpatient admission and emergent surgery. RESULTS: Of 5,642 index emergency department visits for acute urinary stones 11% resulted in at least 1 stone related emergency department revisit within 180 days. Of revisits 59% occurred within 30 days of discharge and 39% were due to pain. The odds of emergency department revisit were highest within the first 48 hours of discharge home (OR 22.6, 95% CI 18.0 to 28.5) and rapidly decreased thereafter. Urology consultation was associated with a 37% lower adjusted odds of emergency department revisit (OR 0.63, 95% CI 0.44 to 0.90) and 68% lower odds of computerized tomography use across all emergency department visits (OR 0.32, 95% CI 0.15 to 0.69). Among patients who revisited the emergency department the frequency of pain complaints was 27% in those with a urological consultation at the index visit and 39% in those without. CONCLUSIONS: Urology consultation was associated with decreased emergency department revisits and computerized tomography use in pediatric patients with urinary stones. Future studies should identify patients who benefit most from urology consultation and ascertain processes of care that decrease emergency department revisits among high risk patients.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2018

Volume

200

Issue

1

Start / End Page

180 / 186

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Calculi
  • Tomography, X-Ray Computed
  • South Carolina
  • Retrospective Studies
  • Referral and Consultation
  • Male
  • Infant, Newborn
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kurtzman, J. T., Song, L., Ross, M. E., Scales, C. D., Chu, D. I., & Tasian, G. E. (2018). Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease. J Urol, 200(1), 180–186. https://doi.org/10.1016/j.juro.2018.02.069
Kurtzman, Jane T., Lihai Song, Michelle E. Ross, Charles D. Scales, David I. Chu, and Gregory E. Tasian. “Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease.J Urol 200, no. 1 (July 2018): 180–86. https://doi.org/10.1016/j.juro.2018.02.069.
Kurtzman JT, Song L, Ross ME, Scales CD, Chu DI, Tasian GE. Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease. J Urol. 2018 Jul;200(1):180–6.
Kurtzman, Jane T., et al. “Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease.J Urol, vol. 200, no. 1, July 2018, pp. 180–86. Pubmed, doi:10.1016/j.juro.2018.02.069.
Kurtzman JT, Song L, Ross ME, Scales CD, Chu DI, Tasian GE. Urology Consultation and Emergency Department Revisits for Children with Urinary Stone Disease. J Urol. 2018 Jul;200(1):180–186.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

July 2018

Volume

200

Issue

1

Start / End Page

180 / 186

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Calculi
  • Tomography, X-Ray Computed
  • South Carolina
  • Retrospective Studies
  • Referral and Consultation
  • Male
  • Infant, Newborn
  • Infant
  • Humans