Infected hydronephrosis: can we reduce patient suffering and costs?
To investigate the correlation among clinical parameters, risk factors, outcomes and costs in the context of patients with infected hydronephrosis.



This retrospective, multi-centric study was conducted in three Romanian academic urology departments, and comprised data of patients with infected hydronephrosis treated between July 2013 and July 2014. Based on per-patient hospitalisation costs, the participants were divided into three groups: group A: cost less than 500 euros), group B: between 500 and 1,000 euros, and group C: over 1,000 euros). Differences between clinical parameters, comorbidities, type of procedure, admission to intensive care unit, length of hospital stay and costs were analysed.



Of the 175 patients, 49(28%) were in group A, 95(54.3%) in group B and 31(17.7%) in group C. The relevant parameters influencing outcomes and costs were age (p=0.001), neoplasical aetiology (p=0.001), leukocytosis (p=0.001), renal insufficiency (p=0.001), and moment of the intervention (p=0.005). Diabetes did not influence the costs (p=0.36). JJ stent insertion was tolerated at least the same as percutaneous nephrostomy, and with the same efficiency.



In order to avoid patient suffering and to reduce costs linked to the treatment of infected hydronephrosis, the patient-general practitioner-specialist collaboration is of the utmost importance. Symptoms, signs, paraclinical features and empirical use of antibiotics may all lead to a delay in proper management, thus making the hospitalisation longer and the costs significantly higher.
Departament of Urology, University of Medicine and Pharmacy "Gr. T. Popa" Iasi, Iasi, Romania.
Catalin
C
Pricop
Parhon Clinic Hospital, Iasi, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures, Bucharest, Romania.
Dragos
D
Puia
Parhon Clinic Hospital, Iasi, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures, Bucharest, Romania.
Oleg
O
Mereuta
Parhon Clinic Hospital, Iasi, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures, Bucharest, Romania.
Catalin
C
Ciuta
Departament of Urology, University of Medicine and Pharmacy "Gr. T. Popa" Iasi, Iasi, Romania.
Liviu
L
Todosi
Departament of Urology, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures, Bucharest, Romania.
Martha
M
Orsolya
Departament of Urology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
George Daniel
GD
Radavoi
D003365:Costs and Cost Analysis; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D009403:Nephrostomy, Percutaneous; D053018:Pyonephrosis / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D012189:Retrospective Studies
Costs, Hydronephrosis, Infection, Sepsis.