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Percutaneous nephrolithotomy in England: practice and outcomes described in the Hospital Episode Statistics database
James N Armitage1, John Withington, Jan van der Meulen
1Department of Urology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
BJU International
|September 24, 2013
Summary
Percutaneous nephrolithotomy (PCNL) complications include hemorrhage and infection, with rare mortality. However, nearly 10% of patients require unplanned hospital readmission within 30 days after PCNL surgery.
Area of Science:
- Urology
- Nephrology
- Health Services Research
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
- Understanding postoperative outcomes is crucial for patient care and hospital quality assessment.
Purpose of the Study:
- To investigate the postoperative outcomes of percutaneous nephrolithotomy (PCNL) in English National Health Service (NHS) hospitals.
- To identify complication rates including hemorrhage, infection, readmission, and mortality.
Main Methods:
- Retrospective analysis of the Hospital Episode Statistics (HES) database.
- Inclusion of all patients undergoing PCNL between March 2006 and January 2011.
- Outcome measures: hemorrhage, infection, emergency readmission, and in-hospital mortality within 30 days.
Main Results:
- 5750 PCNL procedures were analyzed.
- Hemorrhage occurred in 1.4%, urinary tract infection (UTI) in 3.8%, and sepsis in 0.7%.
- 9.0% of patients experienced emergency readmission within 30 days, with UTI and hematuria being common reasons.
Conclusions:
- Hemorrhage and infection are significant complications of PCNL.
- While mortality is rare (0.2%), unplanned readmissions are common (9.0%).
- Complication reporting in the HES database may be incomplete, necessitating validation with other data sources.
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