結石手術後病患再返急診之原因統計及探討
張肇元, 吳維哲, 鍾旭東
亞東紀念醫院 外科部 泌尿科
The reason why patient return to emergency department following ureteroscopic lithotripsy
Chao-Yuan Chang, Wei-Che Wu, Shiu-Dong Chung
Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan

Purpose:
Unexpected Emergency Department return within 3 days after discharge is a significant medical quality indicator. This study aimed to identify the possible reason of this situation.

Materials and Methods:
This is a retrospective study where we reviewed and analyzed all unplanned hospital return to Emergency Department within three days following ureteroscopic laser lithotripsy performed at a single center between January of 2015 and August of 2018. The data were analyzed including patient characteristics, perioperative laboratory data, types and duration of antibiotics use and management at ER.

Results:
For this study, a total of thirty-six patients were reviewed. Intolerable pain 30% (11) and fever 22% (8) were the main reasons of unplanned return. Hematuria 14% (5) and acute urinary retention 11% (4) were also documented. Additionally, there were quite amount of patine 30% (11) returned to Emergency Department due to other problems, such as gastrointestinal symptoms 8% (3), angina 3% (1).

Conclusion:
Pain and fever were associated with a greater likelihood of unexpected Emergency Department return within 3 days following ureteroscopy with laser lithotripsy. Aggressive pain control and additional antibiotics prophylaxis may lead to medical quality improvement.