title: Which factors affect the hospital re-admission and re-hospitalization after flexible ureterorenoscopy for kidney stone?
abstract: OBJECTIVE
  To investigate patient- and procedure-related factors associated with hospital re-admission (HR) and re-hospitalization following flexible ureteroscopy (f-URS).
  
  
  METHODS
  The records of patients who underwent f-URS for renal stones in two reference centers between 2011 and 2015 were examined retrospectively. Patients who were re-admitted to the hospital or re-hospitalized for any reason within 30 days after hospital discharge related to the f-URS procedure were evaluated. The patient- and procedure-related factors affecting the re-admission and re-hospitalization rates were revealed using backward stepwise multiple binary logistic regression analysis.
  
  
  RESULTS
  The study included 647 patients with a mean age of 46.1 ± 13.7 years. The mean BMI was 27.3 ± 4.6 kg/m(2), and the median ASA score was 1.85. The mean stone diameter was 14.2 ± 5.3 mm. The mean operation and fluoroscopy times were 50.2 ± 16.9 min and 43.1 ± 37.6 s, respectively. The mean hospitalization time was 1.42 ± 0.84 days, and the complication rate was 12.8 % (83/647). Overall, 523 (80.3 %) patients became stone-free, while residual fragments <4 mm were detected in 73 (11.3 %) patients. The procedure failed in 7.9 % of the cases. While 82 (12.7 %) patients were re-admitted, 31 (4.8 %) patients were re-hospitalized for further treatment. Stone-free status was an independent predictor of HR, while the stone-free status, hospitalization time, and postoperative complications all predicted re-hospitalization.
  
  
  CONCLUSIONS
  We found that inability to achieve stone-free status predicted HR and re-hospitalization, while postoperative complication and prolonged hospitalization also predicted re-hospitalization.
authors.affiliation: Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Buldu
authors.affiliation: Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. akadirtepeler@yahoo.com.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Tepeler
authors.affiliation: Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Tuna
authors.initials: T
authors.lastname: Karatag
authors.affiliation: Department of Urology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Ozyuvali
authors.affiliation: Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Elbir
authors.affiliation: Department of Urology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yordam
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Unsal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D018666:Ureteroscopy; D055815:Young Adult
keywords: Flexible ureteroscopy; Kidney stone; Re-admission; Re-hospitalization; Risk factor