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Ketorolac is underutilized after ureteral reimplantation despite reduced hospital cost and reduced length of stay.

Publication ,  Journal Article
Routh, JC; Graham, DA; Nelson, CP
Published in: Urology
July 2010

OBJECTIVES: To examine patterns of ketorolac use and its association with hospital outcomes. Although ureteral reimplantation (UR) reliably corrects vesicoureteral reflux, postoperative pain and bladder spasm often occur. Multiple studies show that ketorolac markedly reduces postoperative pain after UR, but there is no information on whether ketorolac is routinely used. METHODS: The Pediatric Health Information System is a national database collected by over 40 US children's hospitals. We identified children with primary vesicoureteral reflux who underwent UR between 2003 and 2008. Billing data were reviewed to identify patients who received ketorolac during hospitalization. Multivariate models were used to examine ketorolac use and postoperative outcomes including complication rates, length of stay, and hospital costs. RESULTS: We identified 12,239 children undergoing UR, 6362 (52%) of whom received ketorolac postoperatively. Factors associated with ketorolac use include older age, female gender, and decreased disease severity (all P <.0001). Ketorolac use was associated with reduced length of stay (2 vs 3 days, P <.0001) and decreased hospital costs ($14,223 vs $16,382, P <.0001). Complication rates were slightly higher in patients not receiving ketorolac (4% vs 3%). After adjusting for confounding factors, ketorolac use remained highly associated with decreased length of stay (P = .01) and decreased costs (P = .002), with no significant differences in complication rates (P = .4). CONCLUSIONS: In a contemporary nationwide sample, only half of children undergoing UR received ketorolac. Ketorolac use is independently associated with reduced procedure costs and reduced length of stay after UR, without increased complications. This suggests underutilization of ketorolac after UR.

Duke Scholars

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

July 2010

Volume

76

Issue

1

Start / End Page

9 / 13

Location

United States

Related Subject Headings

  • Vesico-Ureteral Reflux
  • Urology & Nephrology
  • Ureter
  • Male
  • Length of Stay
  • Ketorolac
  • Infant
  • Humans
  • Hospital Costs
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Routh, J. C., Graham, D. A., & Nelson, C. P. (2010). Ketorolac is underutilized after ureteral reimplantation despite reduced hospital cost and reduced length of stay. Urology, 76(1), 9–13. https://doi.org/10.1016/j.urology.2009.10.062
Routh, Jonathan C., Dionne A. Graham, and Caleb P. Nelson. “Ketorolac is underutilized after ureteral reimplantation despite reduced hospital cost and reduced length of stay.Urology 76, no. 1 (July 2010): 9–13. https://doi.org/10.1016/j.urology.2009.10.062.
Routh, Jonathan C., et al. “Ketorolac is underutilized after ureteral reimplantation despite reduced hospital cost and reduced length of stay.Urology, vol. 76, no. 1, July 2010, pp. 9–13. Pubmed, doi:10.1016/j.urology.2009.10.062.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

July 2010

Volume

76

Issue

1

Start / End Page

9 / 13

Location

United States

Related Subject Headings

  • Vesico-Ureteral Reflux
  • Urology & Nephrology
  • Ureter
  • Male
  • Length of Stay
  • Ketorolac
  • Infant
  • Humans
  • Hospital Costs
  • Female