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MP40-05: Using Data from the California Office of Statewide Health Planning and Development (OSHPD) to determine the 30-day Complication Rate from Urethral-sling Placement.

Saturday, May 13
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Kai Dallas*, Stanford, CA, Christopher Elliott, Santa Clara, CA

Introduction: Surgical intervention for stress urinary incontinence is common with 200,000 repairs annually. The most common repair is mid-urethral sling placement. Although the long-term complication rate after a sling procedure has been rigorously studied, the short -term (30 day) complication rate has been incompletely assessed. We sought to evaluate unplanned hospital visits within 30 days of sling placement in the form of emergency department visits, inpatient admissions, or repeat surgery.

Methods: With approval from the California Protection of Human Subjects committee, we accessed non-public data from the Office of Statewide Health Planning and Development (OSHPD) in the state of California for the years 2005-2011. All female patients who underwent an ambulatory urethral sling procedure (CPT 57288) were identified, excluding other procedures aside from cystoscopy. All emergency department visits, inpatient admissions, and sling revision operations within 30 days of the original surgery were identified. We also examined the most common primary diagnoses associated with emergency department visits.

Results: 28,635 women were identified who underwent outpatient urethral sling placement as a sole procedure (aside from cystoscopy). 1,630 patients had at least one unplanned hospital visit (5.7%) within 30 days. This included 1,327 emergency department visits (4.7%), 295 inpatient admissions (1.0%) and 79 sling revisions (0.28%). The hospital visit rate was significantly higher in patients undergoing a third or fourth sling placement (14.3%) as compared to a first or second sling placement (5.7%) (p=0.02) (table 1). Urinary retention and Foley catheter problem were the most common emergency department visit diagnoses (18.7% of ER visits), followed by urinary tract infection (9.3% of ER visits).

Conclusions: One in eighteen females will have an unplanned hospital visit within 30 days of urethral sling placement, the majority of which are emergency department visits. Our findings can be used to improve patient counseling and suggest target areas to decrease unnecessary emergency department visits in the early postoperative period.

Source Of Funding: None

Kai B. Dallas, MD

Stanford

I was born and raised in Albany, NY. I attended college at Cornell, and focused my studies on biostatistics. I attended medical school at the Icahn School of Medicine (formally the Mount Sinai School of Medicine). I am currently a PGY4 urology resident at Stanford. My research focus includes outcomes and mathmatical modeling in female urology and stone disease.

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MP40-05: Using Data from the California Office of Statewide Health Planning and Development (OSHPD) to determine the 30-day Complication Rate from Urethral-sling Placement.



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