RESUMEN
OBJECTIVE: Reducing readmissions has become a focal point to increase quality of care while reducing costs. We report all-cause unplanned return visits following urologic surgery in children at our institution. MATERIALS AND METHODS: Children undergoing urology procedures with returns within 30 days of surgery were identified. Patient demographics, insurance status, type of surgery, and reason for return were assessed. RESULTS: Four thousand and ninety-seven pediatric urology surgeries were performed at our institution during 2012, with 106 documented unplanned returns (2.59%). Mean time from discharge to return was 5.9 ± 4.9 days (range, 0.3-24.8 days). Returns were classified by chief complaint, including pain (32), infection (30), volume status (14), bleeding (11), catheter concern (8), and other (11). Circumcision, hypospadias repair, and inguinal/scrotal procedures led to the majority of return visits, accounting for 21.7%, 20.7%, and 18.9% of returns, respectively. Twenty-two returns (20.75%) resulted in hospital readmission and five (4.72%) required a secondary procedure. Overall readmission rate was 0.54%, with a reoperation rate of 0.12%. CONCLUSIONS: The rate of unplanned postoperative returns in the pediatric population undergoing urologic surgery is low, further strengthening the argument that readmission rates in children are not necessarily a productive focal point for financial savings or quality control.
Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Procedimientos Quirúrgicos Urológicos/efectos adversos , Factores de Edad , Anestesia General , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Factores de TiempoRESUMEN
The association of limb loss with antenatal urologic intervention has recently been questioned. At present, no such cases have been reported. We present a case of antenatal vesicoamniotic shunting for posterior urethral valves in which the shunt entered the right lower extremity and coursed subcutaneously over the femoral triangle and inguinal canal and into the bladder. Although the limb was intact, we present images and a discussion of the potential for extremity injury with antenatal urologic intervention.