Cost analysis between mini-percutaneous nephrolithotomy with and without vacuum-assisted access sheath.
Cost analysis
Infectious complications
Percutaneous nephrolithotomy
Urolithiasis
Vacuum-assisted percutaneous nephrolithotomy
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
01
07
2021
accepted:
05
08
2021
pubmed:
26
8
2021
medline:
19
2
2022
entrez:
25
8
2021
Statut:
ppublish
Résumé
To perform a cost analysis between vacuum-assisted percutaneous nephrolithotomy (vmPCNL) and minimally invasive PCNL (MIP) and explore potential predictors of costs associated with the procedures. We analyzed data from 225 patients who underwent vmPCNL or MIP at a single tertiary referral academic center between January 2016 and December 2020. We collected patients' demographics, peri-and postoperative data and detailed expense records. After propensity score matching, 108 (66.7%) vmPCNL and 54 (33.3%) MIP procedures were analyzed. Descriptive statistics assessed differences in clinical and operative parameters. Univariable and multivariable linear regression models tested the association between clinical variables and costs. Operative time (OT) was shorter for vmPCNL, and the use of additional instruments to complete litholapaxy was more frequent in MIP (all p ≤ 0.01). Length of stay (LOS) was longer for MIP patients (p = 0.03) and the stone-free (SF) rate was higher after vmPCNL (p = 0.04). The overall instrumentation cost was higher for vmPCNL (p < 0.001), but total procedural costs were equivalent (p = 0.9). However, the overall cost for the hospitalization was higher for MIP than vmPCNL (p = 0.01). Univariable linear regression revealed that patient's comorbidities, OT, any postoperative complication and LOS were associated with hospitalization costs (all p < 0.001). Multivariable linear regression analysis revealed that LOS and OT were associated with hospitalization costs (all p < 0.001), after accounting for vmPCNL procedure, patients' comorbidities, and complications. vmPCNL may represent a valid option due to clinical and economic benefits. Shorter OT, the lower need for disposable equipment and the lower complication rate reduced procedural and hospitalization costs.
Identifiants
pubmed: 34432135
doi: 10.1007/s00345-021-03811-5
pii: 10.1007/s00345-021-03811-5
pmc: PMC8813798
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
201-211Informations de copyright
© 2021. The Author(s).
Références
BJU Int. 2016 Apr;117(4):655-61
pubmed: 26220396
Curr Urol Rep. 2020 Sep 11;21(11):46
pubmed: 32915324
Surg J (N Y). 2020 Feb 12;6(1):e19-e23
pubmed: 32055686
Stat Med. 1998 Oct 15;17(19):2265-81
pubmed: 9802183
World J Urol. 2021 Jul;39(7):2727-2732
pubmed: 32960327
BJU Int. 2020 Jul;126(1):168-176
pubmed: 32279423
Eur Urol. 2012 Aug;62(2):246-55
pubmed: 22487016
Eur Urol. 2021 Jan;79(1):114-121
pubmed: 32994063
J Endourol. 1995 Oct;9(5):375-7
pubmed: 8580935
Eur Urol. 2017 Aug;72(2):220-235
pubmed: 28237786
World J Urol. 2021 Jun;39(6):1717-1723
pubmed: 32591902
J Endourol. 2011 Aug;25(8):1281-6
pubmed: 21745116
Curr Opin Urol. 2021 Mar 1;31(2):95-101
pubmed: 33470685
BJU Int. 2017 Nov;120(5):735-738
pubmed: 28692204
Arch Esp Urol. 2017 Jan;70(1):226-234
pubmed: 28221157
Kaohsiung J Med Sci. 2017 Jan;33(1):36-43
pubmed: 28088272
Urology. 2012 Sep;80(3):524-8
pubmed: 22658621
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
BMC Urol. 2016 Dec 8;16(1):71
pubmed: 27931208
J Endourol. 2021 May;35(5):601-608
pubmed: 33076705
J Endourol. 2018 May;32(5):394-401
pubmed: 29634376
Urolithiasis. 2016 Oct;44(5):445-50
pubmed: 26857367
PLoS One. 2018 Nov 2;13(11):e0205159
pubmed: 30388123
J Endourol. 2020 Mar;34(3):339-344
pubmed: 31950860