Factors that lead to returns to emergency department after urological procedures

Abstract

Purpose:

Many urological procedures are performed as daycare surgeries, allowing for same-day patient discharge. However, this may result in a higher incidence of unplanned emergency department (ED) visits. This study investigates factors contributing to ED return after urological procedures within a 90-day period.

Methods:

This retrospective study analyzed data between January 1, 2018, and January 1, 2022, at a tertiary institution in Riyadh, Saudi Arabia. The analysis assessed parameters associated with complications and explored factors related to ED revisit. Logistic regression analyzes evaluated associations between predictors and ED return rates.

Results:

A total of 797 cases were reviewed, with 218 (27.4%) patients returning to the ED. The mean age of participants was 49.7 years. The majority were male (73.3%). Primary diagnoses included ureter (30.5%), renal (21.6%), and bladder conditions (14.9%). Urinary-related issues accounted for the most common reasons for ED returns (44.0%), followed by pain-related (30.3%) and infection-related causes (11.5%). Univariate analysis indicated that female sex (UOR: 1.53), length of stay (UOR: 1.26), and ASA score (UOR: 1.32) were associated with an increased likelihood of returning to the ED. Multivariate analysis confirmed that female sex (AOR: 1.52), length of stay (AOR: 1.81), and ASA score (AOR: 1.40) significantly predicted ED revisit.

Conclusion:

This study highlights the importance of addressing urinary-related and pain symptoms in postoperative care to reduce ED return. Identifying significant predictors, such as female sex, length of stay, and ASA score, underscores the need for targeted interventions to enhance patient outcomes and reduce unnecessary healthcare utilization.