Failing to follow up: predicting patients that will "no-show" for medically advised imaging following endourologic stone surgery.

医学 输尿管镜检查 经皮肾镜取石术 逻辑回归 心理干预 回顾性队列研究 单变量分析 支架 多元分析 队列 外科 经皮 内科学 输尿管 护理部
作者
Rachel A. Moses,Lawrence Dagrosa,Elias S. Hyams,Peter L. Steinberg,Vernon M. Pais
出处
期刊:PubMed [National Institutes of Health]
卷期号:20 (5): 6939-43 被引量:10
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The purpose of this study is to evaluate predictors of poor compliance after treatment of urinary stone disease.This study was a retrospective analysis of patients who underwent stent removal following percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) between 2008-2012. All patients were scheduled for follow up evaluation and renal ultrasound at 4-6 weeks following stent removal. Patients were stratified based on appointment compliance and demographic variables including gender, age, insurance type (Government Assisted Insurance [GAI] or Private Insurance [PI]), initial procedure, season, distance between home and clinic, average monthly gas price at follow up, and median education attainment. Logistic regression was performed to determine independent predictors of missed follow up.A total of 301 patients were included, 153 women (51% female) with a mean age of 54 ± 14.2 years. Of the cohort, 22.6% (n = 68) did not return for follow up. GAI was the only variable associated with a greater risk of non-compliance on univariate analysis (OR 2.13 [95% CI 1.12-3.86] p = 0.011) and multivariate analysis (OR 3.14.10 [95% CI 1.48-6.7], p < 0.01). Gender, age, procedure, season, distance, gas prices, and education were not significant predictors.In our study, evaluating characteristics associated with missed follow up after stent removal for PCNL and URS, possession of GAI was the only factor associated with non-compliance. Urologists should be aware that persons with GAI may be at increased risk of missed follow up and should use this information to target interventions to improve compliance.

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