Ambulatory PCNL may be cost-effective compared to Standard PCNL
dc.contributor.author | Lee, Matthew S. | |
dc.contributor.author | Assmus, Mark A. | |
dc.contributor.author | Agarwal, Deepak | |
dc.contributor.author | Rivera, Marcelino E. | |
dc.contributor.author | Large, Tim | |
dc.contributor.author | Krambeck, Amy | |
dc.contributor.department | Urology, School of Medicine | en_US |
dc.date.accessioned | 2022-02-02T16:11:49Z | |
dc.date.available | 2022-02-02T16:11:49Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Abstract Background COVID-19 changed the practice of medicine in America. During the March 2020 lockdown, elective cases were cancelled to conserve hospital beds/resources resulting in financial losses for health systems and delayed surgical care. Ambulatory percutaneous nephrolithotomy (aPCNL) has been shown to be safe and could be a strategy to: ensure patients receive care that has been delayed, conserve hospital resources, and maximize cost-effectiveness. We aimed to compare the safety and cost-effectiveness of patients undergoing ambulatory percutaneous nephrolithotomy (aPCNL) against standard PCNL (sPCNL). Materials and Methods 98 patients underwent PCNL at Indiana University Methodist hospital, a tertiary referral center, by three expert surgeons from January 2020 to September 2020. The primary outcome of the study was to compare the 30-day rates of ED-visits, readmissions, and complications between sPCNL and aPCNL. Secondary outcomes included: cost analysis and stone free rates (SFRs). Prospensity-score matching was performed to ensure the groups were balanced. Statistical analyses were performed using SAS 9.4 using independent t-tests for continuous variables and chi-square analyses for categorical variables. Results 98 patients underwent PCNL during the study period (sPCNL=75 and aPCNL=23). After propensity-score matching, 42 patients were available for comparison (sPCNL=19 and aPCNL=23). We found no difference in 30-day ED-visits, readmissions, or complications between the two groups. aPCNL resulted in cost savings of $5327±442 per case. Stone free rates were higher for aPCNL compared to sPCNL. Conclusions aPCNL appears safe to perform and does not have a higher rate of ED-visits or readmissions compare to sPCNL. aPCNL may also be cost-effective compared to sPCNL. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Lee, M. S., Assmus, M. A., Agarwal, D., Rivera, M. E., Large, T., & Krambeck, A. (2021). Ambulatory PCNL may be cost-effective compared to Standard PCNL. Journal of Endourology. https://doi.org/10.1089/end.2021.0482 | en_US |
dc.identifier.issn | 0892-7790, 1557-900X | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/27655 | |
dc.language.iso | en_US | en_US |
dc.publisher | Mary Ann Liebert | en_US |
dc.relation.isversionof | 10.1089/end.2021.0482 | en_US |
dc.relation.journal | Journal of Endourology | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | Author | en_US |
dc.subject | Ambulatory | en_US |
dc.subject | percutaneous nephrolithotomy | en_US |
dc.subject | aPCNL | en_US |
dc.title | Ambulatory PCNL may be cost-effective compared to Standard PCNL | en_US |
dc.type | Article | en_US |