Ambulatory Percutaneous Nephrolithotomy May Be Cost-Effective Compared to Standard Percutaneous Nephrolithotomy

• DOI: 10.1089/end.2021.0482
• Publication Date: 2021-10-19T08:03:14Z
• Authors: Matthew S. Lee; Mark A. Assmus; Deepak K. Agarwal; Marcelino E. Rivera; Tim Large; Amy E. Krambeck
• Keywords: aPCNL; SARS-CoV-2; Cost-Benefit Analysis; COVID-19; Nephrolithotomy, Percutaneous; 3. Good health; Kidney Calculi; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Ambulatory; Communicable Disease Control; Humans; percutaneous nephrolithotomy; Nephrostomy, Percutaneous

Background: Coronavirus disease 2019 (COVID-19) changed the practice of medicine in America. During March 2020 lockdown, elective cases were canceled to conserve hospital beds/resources resulting financial losses for health systems and delayed surgical care. Ambulatory percutaneous nephrolithotomy (aPCNL) has been shown be safe could a strategy ensure patients receive care that delayed, resources, maximize cost-effectiveness. We aimed compare safety cost-effectiveness undergoing aPCNL against standard PCNL (sPCNL). Materials Methods: Ninty-eight underwent at Indiana University Methodist Hospital, tertiary referral center, by three expert surgeons from January September 2020. The primary outcome study was 30-day rates emergency department (ED) visits, readmissions, complications between sPCNL aPCNL. Secondary outcomes included cost analysis stone-free (SFRs). Propensity score matching performed groups balanced. Statistical analyses using SAS 9.4 independent t-tests continuous variables chi-square categorical variables. Results: Ninety-eight during period (sPCNL = 75 23). After propensity matching, 42 available comparison 19 found no difference ED or two groups. resulted savings $5327 ± 442 per case. SFRs higher compared with sPCNL. Conclusions: appears perform does not have rate visits readmissions may also cost-effective