Utilization of Emergency Services After Outpatient Urologic Surgery: A Retrospective Analysis
Abdul-Jawad J. Majeed, Mandy Hsu, Michelle Carraher, Jill S. Patel, Joseph Y. ClarkIntroduction:
Outpatient urologic surgeries have become increasingly common, offering benefits such as reduced hospital stays and improved patient satisfaction. However, unplanned emergency department (ED) visits after these procedures pose challenges for both patients and health care systems.
Methods:
A retrospective cohort study was conducted of adults (older than 18 years) who underwent outpatient urologic surgery at a tertiary academic center during fiscal years 2023 and 2024. Institutional review board approval was obtained. Cases were identified through Vizient Clinical Database/Resource Manager (version 8.12.0.11) and verified by individual chart review. Procedures were categorized by primary surgical focus, and revisit rates were calculated. ED visits occurring within 7 days of the index surgery were flagged for review. Data collected included demographics, procedure type, revisit timing and cause, discharge disposition, and patient calls before ED presentation.
Results:
Among 1583 outpatient surgeries, 3.4% (n = 54) resulted in an unplanned ED visit with a total of 58 encounters. Most occurred after endoscopic procedures, including ureteroscopy for nephrolithiasis (36.3%) and transurethral resection of bladder tumor (34.5%). Most common etiology for revisits included fever/sepsis (21%), urinary retention (16%), and stent colic/extrusion (9%). Only 34.5% of patients contacted the urology service before presenting to the ED.
Conclusion:
The etiology of unplanned ED visits within 7 days after outpatient urologic surgery is multifactorial. Systematic monitoring of these postoperative ED presentations may uncover areas for improvement in the perioperative care pathways and development of targeted interventions. Such efforts have the potential to reduce preventable ED utilization and enhance overall patient outcomes.