Single centre versus multi-centre pooled morbidity data in PCNL and the implications for informed consent.

Area of Science:

• Urology
• Nephrology
• Surgical Outcomes

Background:

• Existing national and international outcome data for PCNL may not represent individual hospital or surgeon performance.
• There is a need for single-center data to provide more accurate outcomes for patient consent.

Purpose of the Study:

• To analyze the outcomes of percutaneous nephrolithotomy (PCNL) at a single center.
• To compare single-center PCNL outcomes with existing multi-center data.
• To inform patient consent processes with accurate, localized outcome data.

Main Methods:

• A combination of retrospective and prospective data from 2000-2016 was collated.
• Data from 801 unique PCNL cases were analyzed.
• Outcomes were compared against published large single and multi-center series.

Main Results:

• The mean hemoglobin drop was 1.65 g/dL, with a 3.37% transfusion rate.
• Pre-operative bacteriuria (25%) was noted, but not significantly linked to increased hemoglobin drop.
• Low rates of complications were observed, including 1% requiring higher care, 0.75% needing embolization for bleeding, and no peri-operative deaths.

Conclusions:

• Single-center outcome data for PCNL provides a more accurate reflection of performance.
• Utilizing single-center data is crucial for facilitating transparent patient consent.
• This study demonstrates favorable outcomes and low complication rates in PCNL performed at a single institution.