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Is an overnight stay after percutaneous nephrolithotomy safe?
OBJECTIVES: To establish a clinical care pathway that plans for hospital discharge the day after percutaneous nephrolithotomy (PCNL), to evaluate the safety, effectiveness and feasibility of this pathway, and to identify factors associated with a postoperative length of hospital stay (LOS) of >1 ...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442911/ https://www.ncbi.nlm.nih.gov/pubmed/26558051 http://dx.doi.org/10.1016/j.aju.2012.07.006 |
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author | Alyami, Fahad Norman, Richard W. |
author_facet | Alyami, Fahad Norman, Richard W. |
author_sort | Alyami, Fahad |
collection | PubMed |
description | OBJECTIVES: To establish a clinical care pathway that plans for hospital discharge the day after percutaneous nephrolithotomy (PCNL), to evaluate the safety, effectiveness and feasibility of this pathway, and to identify factors associated with a postoperative length of hospital stay (LOS) of >1 day. PCNL is the treatment of choice for patients with large kidney stones and those in whom extracorporeal shockwave lithotripsy has failed, and the mean LOS is typically 2–5 days. PATIENTS AND METHODS: We retrospectively reviewed the charts of 109 patients (mean age 57.4 years; 58 men, 53%) who had PCNL between 2006 and 2009. All had nephrostomy tubes placed after surgery. The patients’ demographics, LOS, incidence of complications, clinical outcomes, stone-free rates, number of early postoperative emergency-room visits, need for subsequent admission and/or other procedures, were noted and analysed. The modified Clavien classification was used to describe the postoperative complications. Bivariate analyses were used to test for associations between LOS and other variables. RESULTS: The mean (range) stone size was 2.2 (0.9–5.9) cm, and the mean (SEM) LOS was 1.7 (0.13) days. Of the 109 patients, 20% had a LOS of >1 day for surgical, 3% for medical and 5% for social reasons. The stone-free rate was 89%. There was no difference in the number of subsequent hospital visits or ancillary procedures for patients discharged after one or more postoperative nights. No variables were associated with a longer LOS. CONCLUSIONS: An overnight hospital stay after PCNL is safe and represents an effective strategy for improved bed use in selected patients. A longer LOS was not affected by patient age or body mass index, stone size or operative time. We continue to use our clinical care pathway, as supported by these data. |
format | Online Article Text |
id | pubmed-4442911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-44429112015-11-10 Is an overnight stay after percutaneous nephrolithotomy safe? Alyami, Fahad Norman, Richard W. Arab J Urol Stones/Endourology Original article OBJECTIVES: To establish a clinical care pathway that plans for hospital discharge the day after percutaneous nephrolithotomy (PCNL), to evaluate the safety, effectiveness and feasibility of this pathway, and to identify factors associated with a postoperative length of hospital stay (LOS) of >1 day. PCNL is the treatment of choice for patients with large kidney stones and those in whom extracorporeal shockwave lithotripsy has failed, and the mean LOS is typically 2–5 days. PATIENTS AND METHODS: We retrospectively reviewed the charts of 109 patients (mean age 57.4 years; 58 men, 53%) who had PCNL between 2006 and 2009. All had nephrostomy tubes placed after surgery. The patients’ demographics, LOS, incidence of complications, clinical outcomes, stone-free rates, number of early postoperative emergency-room visits, need for subsequent admission and/or other procedures, were noted and analysed. The modified Clavien classification was used to describe the postoperative complications. Bivariate analyses were used to test for associations between LOS and other variables. RESULTS: The mean (range) stone size was 2.2 (0.9–5.9) cm, and the mean (SEM) LOS was 1.7 (0.13) days. Of the 109 patients, 20% had a LOS of >1 day for surgical, 3% for medical and 5% for social reasons. The stone-free rate was 89%. There was no difference in the number of subsequent hospital visits or ancillary procedures for patients discharged after one or more postoperative nights. No variables were associated with a longer LOS. CONCLUSIONS: An overnight hospital stay after PCNL is safe and represents an effective strategy for improved bed use in selected patients. A longer LOS was not affected by patient age or body mass index, stone size or operative time. We continue to use our clinical care pathway, as supported by these data. Elsevier 2012-12 2012-08-29 /pmc/articles/PMC4442911/ /pubmed/26558051 http://dx.doi.org/10.1016/j.aju.2012.07.006 Text en © 2012 Arab Association of Urology. Production and hosting by Elsevier B.V. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). |
spellingShingle | Stones/Endourology Original article Alyami, Fahad Norman, Richard W. Is an overnight stay after percutaneous nephrolithotomy safe? |
title | Is an overnight stay after percutaneous nephrolithotomy safe? |
title_full | Is an overnight stay after percutaneous nephrolithotomy safe? |
title_fullStr | Is an overnight stay after percutaneous nephrolithotomy safe? |
title_full_unstemmed | Is an overnight stay after percutaneous nephrolithotomy safe? |
title_short | Is an overnight stay after percutaneous nephrolithotomy safe? |
title_sort | is an overnight stay after percutaneous nephrolithotomy safe? |
topic | Stones/Endourology Original article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442911/ https://www.ncbi.nlm.nih.gov/pubmed/26558051 http://dx.doi.org/10.1016/j.aju.2012.07.006 |
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