Return to emergency department after pediatric urology procedures

Area of Science:

• Pediatric Urology
• Healthcare Quality Improvement
• Surgical Outcomes

Background:

• Unplanned postoperative emergency department (ED) visits and readmissions are key quality indicators and significant cost drivers in healthcare.
• Evaluating these events after pediatric urology procedures is crucial for identifying areas of improvement.

Purpose of the Study:

• To assess the rate of ED return visits following pediatric urology procedures at a tertiary children's hospital.
• To identify potential causes and associated factors for these return visits.
• To establish a baseline for future quality improvement initiatives.

Main Methods:

• Retrospective study of pediatric urology cases from October 2012 to September 2015.
• Analysis of patient demographics, surgical details, and anesthesia information.
• Review of ED records for patients returning within 30 days, identifying reasons and management.
• Statistical analysis using logistic regression to determine factors associated with ED return.

Main Results:

• Out of 4125 cases, 349 (8.5%) returned to the ED within 30 days.
• Urinary tract infection (UTI) was the most common reason (17.2%), followed by stent/catheter issues (14.3%) and wound problems (14.3%).
• Factors associated with ED return included younger age, inpatient admission, inguinoscrotal surgery, and longer operative duration.

Conclusions:

• The study identified an 8.5% ED return rate after pediatric urology procedures, higher than some US benchmarks.
• Common reasons for return visits, such as UTI and device issues, suggest areas for targeted interventions.
• The majority of ED returns were managed conservatively, indicating a potential for prevention through improved postoperative care and patient education.