Multivariate Cox survival analysis of unplanned readmissions in patients undergoing retrograde intrarenal surgery for day surgery

LI Yu; HUANG Li-yan; QIN Li-yuan; QIN Mei-bin

doi:10.13820/j.cnki.gdyx.20240974

Abstract：Objective To investigate and analyze the factors influencing unplanned readmissions in patients dis-charged after retrograde intrarenal surgery(RIRS)for stone removal in a day surgery setting.This study aims to provide clinical insights and evidence for post-discharge continuous care in patients undergoing RIRS.Methods A total of 234 patients who underwent RIRS as day surgery and were discharged between May 2021 and June 2023 were included in the study.Patients were categorized into two groups:the normal group(n=219,with no readmissions related to the surgery within 30 days post-discharge)and the unplanned readmission group(n=15,with unplanned readmissions due to relat-ed or identical conditions within 30 days post-discharge).Univariate and multivariate Cox regression analyses were per-formed to identify independent influencing factors.Results The incidence of unplanned readmissions was 6.41％.Multi-variate Cox regression analysis revealed that longer surgery duration[hazard ratio(HR)=1.023,95％confidence interval(CI)=1.001-1.045,P=0.039],postoperative infection(HR=1.162,95％CI=1.023-1.321,P=0.021),and intraoperative bleeding(HR=0.953,95％CI=0.921-0.987,P=0.006)were independent risk factors associated with unplanned readmissions after RIRS day surgery.Conclusion Reducing surgery duration,proactively preventing and managing postoperative infections,and providing comprehensive post-discharge care can effectively prevent unplanned re-admissions in RIRS day surgery patients.Continuous care post-discharge is essential in preventing complications such as delayed hemorrhage due to inadequate activity,thereby reducing the likelihood of unplanned readmissions.