Patient morbidity and costs of long-term indwelling nephrostomy tubes: Benefits of a urology led service
Author(s):
Mr Wesam Elbaroni
,
Mr Wesam Elbaroni
Affiliations:
Ms Siobhan Woolsey
,
Ms Siobhan Woolsey
Affiliations:
Mr Trevor Thompson
,
Mr Trevor Thompson
Affiliations:
Mr David Connolly
Mr David Connolly
Affiliations:
BAUS ePoster online library. Elbaroni W. 06/26/17; 177352; P2-6 Disclosure(s): none to disclose
Mr. Wesam A Amru Elbaroni
Mr. Wesam A Amru Elbaroni
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)
Introduction:
Patients with ureteric obstruction who are not suitable for reconstructive surgery can be managed with long-term percutaneous nephrostomy (PCN) tube drainage. These require regular exchanges to prevent obstruction or infection. In our institution, PCN exchanges are performed at a dedicated urology session. Ongoing morbidity and costs of PCN were recorded. Potential benefits of having a urology-led PCN exchange service were assessed.

Methods:

We retrospectively reviewed all patients who had PCN exchange at a urology-led session between Sept 2013 and Dec 2015. Clinical progress, complications, overall costs and management changes due to concurrent Urology review were recorded.

Results:
329 PCN exchanges were performed in 80 patients. Mean age was 69.3 years (range 24-95 years). 23 (28.8%) patients had an underlying malignancy. 14 (17.5%) patients died during follow-up. In all cases, the reason for nephrostomy insertion and alternative treatment options were discussed. 29 patients (33.75%) had an immediate change in their management due to concurrent urological review (Table1). 36 (45%) had unplanned admissions during follow-up (Table 2). 23 (28.9%) patients had urgent exchanges due to dislodged, blocked or leaking tubes. The total hospital stay for one year of follow-up due to complications was 81.5 day, which generates a cost of 42,738 Euro.

Conclusions:
Long-term PCN drainage is associated with significant patient morbidity and healthcare costs. Alternatives to PCN drainage should be sought where possible. Urologists can safely perform PCN exchanges. A urology-led service improves clinical decision-making and continuity of care, with a decreased need for out-patient reviews.
Introduction:
Patients with ureteric obstruction who are not suitable for reconstructive surgery can be managed with long-term percutaneous nephrostomy (PCN) tube drainage. These require regular exchanges to prevent obstruction or infection. In our institution, PCN exchanges are performed at a dedicated urology session. Ongoing morbidity and costs of PCN were recorded. Potential benefits of having a urology-led PCN exchange service were assessed.

Methods:

We retrospectively reviewed all patients who had PCN exchange at a urology-led session between Sept 2013 and Dec 2015. Clinical progress, complications, overall costs and management changes due to concurrent Urology review were recorded.

Results:
329 PCN exchanges were performed in 80 patients. Mean age was 69.3 years (range 24-95 years). 23 (28.8%) patients had an underlying malignancy. 14 (17.5%) patients died during follow-up. In all cases, the reason for nephrostomy insertion and alternative treatment options were discussed. 29 patients (33.75%) had an immediate change in their management due to concurrent urological review (Table1). 36 (45%) had unplanned admissions during follow-up (Table 2). 23 (28.9%) patients had urgent exchanges due to dislodged, blocked or leaking tubes. The total hospital stay for one year of follow-up due to complications was 81.5 day, which generates a cost of 42,738 Euro.

Conclusions:
Long-term PCN drainage is associated with significant patient morbidity and healthcare costs. Alternatives to PCN drainage should be sought where possible. Urologists can safely perform PCN exchanges. A urology-led service improves clinical decision-making and continuity of care, with a decreased need for out-patient reviews.
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies