ArticleIrish journal of medical science2022
Emergency urolithiasis management at a national level: exploring the need for a care pathway.
Article in Irish journal of medical science, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUrolithiasis is a common urological presentation
aimsTo examine length of stay (LOS) and transfer patterns for patients presenting with urolithiasis to Irish Model 2/3 hospitals without a specialist urology service, compared with those who present to a model 4 hospital with an on-site urology service.
methodsUsing the National Quality Assurance & Improvement System (NQAIS), we assessed patients presenting with urolithiasis, nationally from January 2016 to December 2019.
resultsDuring the study period, there were 11,856 emergency presentations with urolithiasis. A total of 6510 (54.9%) presented to model 4 hospitals, while 5346 (45.1%) presented to model 2/3 hospitals. A total of 874 (16.35%) patients required transfer from model 2/3 hospital to a model 4 hospital for further management. Those transferred from model 2/3 hospitals spent a mean of 3.68 days awaiting transfer and had a mean LOS of 3.88 days in the model 4 hospital. A total of 7.56 days compared with a mean LOS of 2.9 days for those presenting directly to a model 4 hospital.
conclusionAt a national level in Ireland, many patients with urolithiasis present to hospitals that are unable to cater for their needs. Patients presenting with urolithiasis to model 2/3 hospitals have significantly longer LOS compared with patients who present directly to a model 4 hospital. A formal 'stone pathway' is required to provide timely care for these patients
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