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Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy.

Publication ,  Journal Article
Carlos, EC; Peters, CE; Wollin, DA; Winship, BB; Davis, LG; Li, J; Scales, CD; Eaton, SH; Preminger, GM; Lipkin, ME
Published in: J Urol
March 2019

PURPOSE: Emergency department visits after ureteroscopy are costly and inconvenient. To better understand those at risk we aimed to identify patient demographic, medical and surgical factors associated with 30-day emergency department presentation following ureteroscopy for urolithiasis with particular attention to those with a history of a psychiatric diagnosis. MATERIALS AND METHODS: We retrospectively reviewed 1,576 cases (1,395 adults) who underwent stone related ureteroscopy during 3 years at a total of 2 hospitals. We collected patient demographics, medical history and operative details. The primary outcome was return to the emergency department within 30 days of ureteroscopy. Logistic regression was performed to examine factors associated with emergency department presentation. RESULTS: Of the patients 613 (43.9%) had a history of psychiatric diagnosis. Of those with ureteroscopy encounters 12.6% returned to the emergency department within 30 days of ureteroscopy, including 58.8% with a history of psychiatric diagnosis. On multivariable analysis variables associated with emergency department return included a history of psychiatric diagnosis (OR 1.57, p = 0.012), uninsured status (OR 2.46, p = 0.001) and a stone only in the kidney (OR 1.76, p = 0.022). Patients who returned to the emergency department had had more emergency department visits in the year prior to surgery (OR 1.40, p <0.001). On univariable analysis older patients and those with longer operative time were more frequently admitted from the emergency department (OR 1.03, p = 0.002 and OR 1.96, p = 0.03. respectively) while uninsured patients were admitted less frequently (OR 0.19, p = 0.013). No difference was noted in admissions between those with a psychiatric diagnosis and all others (60.7% vs 55.8%, p = 0.48). CONCLUSIONS: We identified factors associated with emergency department return after ureteroscopy, including a history of psychiatric diagnosis, uninsured status and emergency department visits in the year before surgery. These patients may benefit from targeted interventions to help avoid unnecessary emergency department visits.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

March 2019

Volume

201

Issue

3

Start / End Page

556 / 562

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urolithiasis
  • Ureteroscopy
  • Risk Factors
  • Retrospective Studies
  • Middle Aged
  • Mental Disorders
  • Medically Uninsured
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Carlos, E. C., Peters, C. E., Wollin, D. A., Winship, B. B., Davis, L. G., Li, J., … Lipkin, M. E. (2019). Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy. J Urol, 201(3), 556–562. https://doi.org/10.1016/j.juro.2018.09.062
Carlos, Evan C., Chloe E. Peters, Daniel A. Wollin, Brenton B. Winship, Leah G. Davis, Jingqiu Li, Charles D. Scales, Samuel H. Eaton, Glenn M. Preminger, and Michael E. Lipkin. “Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy.J Urol 201, no. 3 (March 2019): 556–62. https://doi.org/10.1016/j.juro.2018.09.062.
Carlos EC, Peters CE, Wollin DA, Winship BB, Davis LG, Li J, et al. Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy. J Urol. 2019 Mar;201(3):556–62.
Carlos, Evan C., et al. “Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy.J Urol, vol. 201, no. 3, Mar. 2019, pp. 556–62. Pubmed, doi:10.1016/j.juro.2018.09.062.
Carlos EC, Peters CE, Wollin DA, Winship BB, Davis LG, Li J, Scales CD, Eaton SH, Preminger GM, Lipkin ME. Psychiatric Diagnoses and Other Factors Associated with Emergency Department Return within 30 Days of Ureteroscopy. J Urol. 2019 Mar;201(3):556–562.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

March 2019

Volume

201

Issue

3

Start / End Page

556 / 562

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urolithiasis
  • Ureteroscopy
  • Risk Factors
  • Retrospective Studies
  • Middle Aged
  • Mental Disorders
  • Medically Uninsured
  • Male
  • Humans