TY - JOUR
T1 - Simple Nephrectomy in a Tertiary Care Safety Net Hospital—Patient Characteristics, Causes, Cost, and Renal Function Implications
AU - Ames, Kyle S.
AU - Baky, Fady
AU - Blair, Somer
AU - Sanchez, Jorge
AU - Franklin, Whitney
AU - Barefoot, Andrew
AU - Mears, Jessica
AU - Magness, Patricia
AU - Johnson, Brett
AU - Bakare, Tolulope
AU - Hudak, Steve
AU - Antonelli, Jodi
AU - Hutchinson, Ryan
AU - Lotan, Yair
AU - Woldu, Solomon L.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/3
Y1 - 2021/3
N2 - Objective: To evaluate factors associated with simple nephrectomy at a safety net hospital with a diverse patient population and large catchment area. Simple nephrectomy is an underreported surgery. Performance of simple nephrectomy may represent a failure of management of underlying causes. Methods: We performed a retrospective review of simple nephrectomies performed at a major urban safety net hospital from 2014 to 2019. Detailed demographic, surgical, and renal functional outcomes were abstracted. We assessed the medical and social factors leading to performance of simple nephrectomy and report contemporaneous perception of preventability of the simple nephrectomy by the surgeon. Results: Eighty-five patients underwent simple nephrectomy during the study period; 55% were non-white, 77% were women, and the median age at time of surgery was 46 years. The most common medical factors contributing to simple nephrectomy were stone disease in 55.3%, followed by retained ureteral stent (30.6%) and stricture (30.6%). The most common social factors were lack of insurance (58.5%), substance abuse issues (32.3%), mental health issues (24.6%), and immigration status (18.5%). In 38.8% of cases, the provider felt the surgery was preventable if medical factors leading to simple nephrectomy were properly addressed. Conclusions: Simple nephrectomy is a common surgery in the safety net hospital setting. Both medical and sociologic factors can lead to simple nephrectomy, and awareness of these factors can lead efforts to mitigate them. This review has led to the implementation of strategies to minimize occurrences of retained stents in our patients.
AB - Objective: To evaluate factors associated with simple nephrectomy at a safety net hospital with a diverse patient population and large catchment area. Simple nephrectomy is an underreported surgery. Performance of simple nephrectomy may represent a failure of management of underlying causes. Methods: We performed a retrospective review of simple nephrectomies performed at a major urban safety net hospital from 2014 to 2019. Detailed demographic, surgical, and renal functional outcomes were abstracted. We assessed the medical and social factors leading to performance of simple nephrectomy and report contemporaneous perception of preventability of the simple nephrectomy by the surgeon. Results: Eighty-five patients underwent simple nephrectomy during the study period; 55% were non-white, 77% were women, and the median age at time of surgery was 46 years. The most common medical factors contributing to simple nephrectomy were stone disease in 55.3%, followed by retained ureteral stent (30.6%) and stricture (30.6%). The most common social factors were lack of insurance (58.5%), substance abuse issues (32.3%), mental health issues (24.6%), and immigration status (18.5%). In 38.8% of cases, the provider felt the surgery was preventable if medical factors leading to simple nephrectomy were properly addressed. Conclusions: Simple nephrectomy is a common surgery in the safety net hospital setting. Both medical and sociologic factors can lead to simple nephrectomy, and awareness of these factors can lead efforts to mitigate them. This review has led to the implementation of strategies to minimize occurrences of retained stents in our patients.
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U2 - 10.1016/j.urology.2020.12.013
DO - 10.1016/j.urology.2020.12.013
M3 - Article
C2 - 33359487
AN - SCOPUS:85098739623
SN - 0090-4295
VL - 149
SP - 98
EP - 102
JO - Urology
JF - Urology
ER -