Unplanned Hospital Visits in the First 30 Days Following Midurethral Sling

Fan Y1, Chung H1, Huang Y1, Lin C1, Lin A T1

Research Type

Clinical

Abstract Category

Female Stress Urinary Incontinence (SUI)

Abstract 238
Female Stress Urinary Incontinence
Scientific Podium Short Oral Session 12
Wednesday 29th August 2018
16:30 - 16:37
Hall B
Female Stress Urinary Incontinence Surgery
1. Taipei Veterans General Hospital, Taipei, Taiwan
Presenter
Y

Yu-Hua Fan

Links

Abstract

Hypothesis / aims of study
To evaluate unplanned hospital visits within 30 days of midurethral sling placement in the form of emergency department visits, inpatient admissions, or repeat surgery.
Study design, materials and methods
We included female patients who underwent midurethral sling without concomitant surgery (other than cystoscopy) and aged 20 years or older from a urology dataset including 3,431,366 individuals selected from the National Health Insurance Research Database for the year 2006 to 2010. Patients were evaluated for any unplanned hospital visits occurring within 30 days of index midurethral sling. These encounters were defined as adverse events or complications. These events or complications were categorized as: (1) outpatient surgery; (2) inpatient surgery; (3) inpatient admission; or (4) emergency department visit. Furthermore, we analyzed the risk factors associated with unplanned hospital visits after midurethral sling.
Results
We identified 2894 female patients who underwent 2939 sling procedures between July 2007 and November 2010. Within 30 days, 210 sling procedures (7.1%) were accompanied by at least 1 unplanned hospital visit. This included 123 emergency department visits (4.2%), 72 inpatient admissions (2.4%), 22 inpatient surgeries (0.7%), and 9 outpatient surgeries (0.3%). Urinary tract infection and lower urinary tract symptoms were the most common emergency department visit diagnoses (25.6% of visits). Only two (1.5% of visits) visited emergency department due to urinary retention. Similarly, urinary tract infection and sling-related complications were the most common inpatient admission diagnoses (26.4% of admissions). Interestingly, diagnosis of psychiatric or emotional disorders occupied 16.7% of inpatient admissions. 75% of these patients had a past history of psychiatric or emotional disorders. In addition to hypertension, a patient’s individual comorbidities were not associated with unplanned hospital visits after midurethral sling. Furthermore, hospital accreditations, patients’ age, preoperative urinary tract infection and surgeons’ specialties didn’t affect unplanned hospital visits after midurethral sling.
Interpretation of results
The unplanned 30-day hospital visit rate following a midurethral sling procedure for female SUI is low at 7.1%. The majority of visits is to emergency departments, and around a quarter of these visits is for urinary tract infection or lower urinary tract symptoms. Women with the history of psychiatric or emotional disorders are prone to acute exacerbation-related inpatient admissions within 30 days of midurethral sling placement.
Concluding message
Our findings can be used to improve patient counseling and addressing these areas may reduce the number of unplanned visits after sling surgery.
Disclosures
<span class="text-strong">Funding</span> None <span class="text-strong">Clinical Trial</span> No <span class="text-strong">Subjects</span> Human <span class="text-strong">Ethics Committee</span> Taipei Veterans General Hospital <span class="text-strong">Helsinki</span> Yes <span class="text-strong">Informed Consent</span> Yes