Upper Urinary Tract
Percutaneous nephrolithotomy in England: practice and outcomes described in the Hospital Episode Statistics database
- To investigate the postoperative outcomes of percutaneous nephrolithotomy (PCNL) in English National Health Service (NHS) hospitals.
Patients and Methods
- We extracted records from the Hospital Episode Statistics (HES) database for all patients undergoing PCNL between March 2006 and January 2011 in English NHS hospitals.
- Outcome measures were haemorrhage, infection within the index admission, and rates of emergency readmission and in-hospital mortality within 30 days of surgery.
- A total of 5750 index PCNL procedures were performed in 165 hospitals.
- During the index admission, haemorrhage was recorded in 81 patients (1.4%), 192 patients (3.8%) had a urinary tract infection (UTI), 95 patients (1.7%) had fever, and 41 patients (0.7%) had sepsis.
- There were 595 emergency readmissions in 518 patients (9.0%). Reasons for readmission were varied: 70 (1.2%) with UTI, 15 (0.3%) sepsis, 73 (1.3%) haematuria, 25 (0.4%) haemorrhage, and 25 (0.4%) acute urinary retention.
- There were 13 (0.2%) in-hospital deaths within 30 days of surgery.
- Haemorrhage and infection represent relatively common and potentially severe complications of PCNL.
- Mortality is extremely rare after PCNL (about one in 400 procedures overall) but almost one in 10 patients have an unplanned hospital readmission within 30 days of surgery.
- Complications of PCNL may be under-reported in the HES database and need to be corroborated using other data sources.