Percutaneous Nephrolithotomy in Patients with Spina Bifida and Spinal Injury: A Comparative Analysis of Over 4000 Patients, from the BAUS PCNL Registry
Author(s):
Mr John Withington
,
Mr John Withington
Affiliations:
Mr James Armitage
,
Mr James Armitage
Affiliations:
Ms Sarah Fowler
,
Ms Sarah Fowler
Affiliations:
Mr William Finch
,
Mr William Finch
Affiliations:
Mr Stuart Irving
,
Mr Stuart Irving
Affiliations:
Mr Jonathan Glass
,
Mr Jonathan Glass
Affiliations:
Mr Neil Burgess
,
Mr Neil Burgess
Affiliations:
Mr Oliver Wiseman
Mr Oliver Wiseman
Affiliations:
BAUS ePoster online library. Withington J. 06/26/17; 177364; P3-8
Mr. John Withington
Mr. John Withington
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Abstract
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Introduction
PCNL in patients with spina bifida, spinal injuries or other major spinal deformities entails significant technical and perioperative complexity. These patients’ outcomes must be comprehensively understood if we are to mitigate for this complexity and improve care.

The BAUS PCNL registry records information on spina bifida and spinal comorbidity, as well as stone clearance and complications, allowing comparisons with all other patients.

Patients and Methods
The study used data from the BAUS PCNL registry from 31st January 2014 and 31st December 2015. A series of comparisons of outcomes was made between patients with and without spinal comorbidities.

Results
4166 records were retrieved from the registry, comprising 88 patients with spina bifida or spinal injury (2.1%) and 4078 (97.9%) without.

Mean length of stay was 6.8 days in patients with spinal comorbidity and 3.8 in patients without. Transfusion rates were 2.5% and 2.4%, respectively. Sepsis was much commoner in the spinal comorbidity group (13.6% vs 2.9%). Overall complication rates were 13.6% and 7.9%, respectively. Stone clearance was also better in the group without spinal comorbidity (72.6% vs 63.6%).

Conclusion
Spina bifida and spinal injury are associated with longer lengths of stay, higher rates of sepsis and complications and lower rates of stone clearance. These patients seem likely to benefit, therefore from the care of experienced multidisciplinary teams.

Given their relatively low numbers at individual institutions, the BAUS registry provides a powerful resource for studying outcomes and measuring improvements in the care of these patients.
Introduction
PCNL in patients with spina bifida, spinal injuries or other major spinal deformities entails significant technical and perioperative complexity. These patients’ outcomes must be comprehensively understood if we are to mitigate for this complexity and improve care.

The BAUS PCNL registry records information on spina bifida and spinal comorbidity, as well as stone clearance and complications, allowing comparisons with all other patients.

Patients and Methods
The study used data from the BAUS PCNL registry from 31st January 2014 and 31st December 2015. A series of comparisons of outcomes was made between patients with and without spinal comorbidities.

Results
4166 records were retrieved from the registry, comprising 88 patients with spina bifida or spinal injury (2.1%) and 4078 (97.9%) without.

Mean length of stay was 6.8 days in patients with spinal comorbidity and 3.8 in patients without. Transfusion rates were 2.5% and 2.4%, respectively. Sepsis was much commoner in the spinal comorbidity group (13.6% vs 2.9%). Overall complication rates were 13.6% and 7.9%, respectively. Stone clearance was also better in the group without spinal comorbidity (72.6% vs 63.6%).

Conclusion
Spina bifida and spinal injury are associated with longer lengths of stay, higher rates of sepsis and complications and lower rates of stone clearance. These patients seem likely to benefit, therefore from the care of experienced multidisciplinary teams.

Given their relatively low numbers at individual institutions, the BAUS registry provides a powerful resource for studying outcomes and measuring improvements in the care of these patients.
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