Risk Factors for Readmission after Shock Wave Lithotripsy for Urinary Stones

Area of Science:

• Urology
• Nephrology
• Endourology

Background:

• Rising healthcare costs necessitate reducing complications and rehospitalization after procedures.
• Shock wave lithotripsy (SWL) is a common treatment for kidney and ureteral stones.
• Understanding readmission predictors is crucial for optimizing SWL patient care.

Purpose of the Study:

• To analyze the 90-day readmission and emergency department (ED) presentation rates following SWL.
• To identify prognostic risk factors associated with SWL-related readmissions and ED visits.
• To evaluate stone-free rates post-SWL and associated predictors.

Main Methods:

• Retrospective review of 577 patients undergoing SWL for renal or ureteral stones (≤2.0 cm) between January 2011 and May 2013.
• Primary outcome: 90-day readmission or ED presentation.
• Secondary outcomes: 30- and 90-day stone-free rates. Statistical analysis included univariate and multivariate logistic regression.

Main Results:

• The 90-day readmission rate was 11.6%.
• Urgency of the procedure was the only significant predictor of readmission.
• Renal colic (67%) was the most common reason for readmission. Stone-free rates were 57% (30-day) and 78% (90-day), predicted by stone size and non-urgent SWL status.

Conclusions:

• The 90-day readmission rate after SWL is 11.6%, with procedure urgency being a significant predictor.
• Stone centers should monitor SWL readmission rates to establish benchmarks and inform treatment decisions.
• Identifying predictors like procedural urgency can guide the selection of alternative endourological treatments when necessary.