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Purpose <p>To evaluate the impact of early surgical intervention on outcomes in patients admitted non-electively for macroscopic hematuria, a clinical scenario with limited prior research.</p> Methods <p>We conducted a single-center, retrospective observational study including 261 consecutive patients admitted non-electively with a primary diagnosis of macroscopic hematuria to the Urology Department at Hospital Universitario 12 de Octubre, Spain, between January 2016 and June 2021. Patients were stratified into three groups: no surgical intervention, surgical intervention within 5&#xa0;days, and surgical intervention after 5&#xa0;days. Baseline characteristics, 365-day readmissions, and mortality were analyzed using binary logistic regression, zero-inflated Poisson, and Cox proportional hazards models.</p> Results <p>The median age was 82&#xa0;years and the median Charlson Comorbidity Index was 6. Crude 365-day readmission and mortality rates were 50.6% and 30.7%, respectively. Patients who underwent surgical intervention had lower 365-day mortality (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.32–0.97, <i>p</i> = 0.038) and readmission rates (odds ratio [OR] 0.28, 95% CI 0.15–0.54, <i>p</i> &lt; 0.001). Significant risk factors for 365-day mortality included red blood cell transfusion (HR 2.12, 95% CI 1.29–3.49, <i>p</i> = 0.003), higher Charlson Comorbidity Index (HR 9.16, 95% CI 2.22–37.54, <i>p</i> = 0.002), and greater disease complexity (HR 2.35, 95% CI 1.63–3.39, <i>p</i> &lt; 0.001). The single-center, retrospective design limits the generalizability of these findings.</p> Conclusions <p>In this cohort of elderly patients with substantial comorbidity, early surgical intervention, when clinically indicated, was associated with significantly reduced 365-day mortality and readmission rates.</p>

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Impact of early surgical intervention on 1-year outcomes in patients hospitalized for macroscopic hematuria: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年7月23日

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  • Cristina Calzas Montalvo,
  • Javier Martín Arranz,
  • Jose L. Bernal Sobrino,
  • Silvia Juste Álvarez,
  • Víctor Quirós González,
  • Noelia García Barrio,
  • María P. Caro González,
  • Natalia R. Miranda Utrera,
  • Javier Gil Moradillo,
  • Alfredo Rodríguez Antolín,
  • Ángel Tejido Sánchez

摘要

Purpose

To evaluate the impact of early surgical intervention on outcomes in patients admitted non-electively for macroscopic hematuria, a clinical scenario with limited prior research.

Methods

We conducted a single-center, retrospective observational study including 261 consecutive patients admitted non-electively with a primary diagnosis of macroscopic hematuria to the Urology Department at Hospital Universitario 12 de Octubre, Spain, between January 2016 and June 2021. Patients were stratified into three groups: no surgical intervention, surgical intervention within 5 days, and surgical intervention after 5 days. Baseline characteristics, 365-day readmissions, and mortality were analyzed using binary logistic regression, zero-inflated Poisson, and Cox proportional hazards models.

Results

The median age was 82 years and the median Charlson Comorbidity Index was 6. Crude 365-day readmission and mortality rates were 50.6% and 30.7%, respectively. Patients who underwent surgical intervention had lower 365-day mortality (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.32–0.97, p = 0.038) and readmission rates (odds ratio [OR] 0.28, 95% CI 0.15–0.54, p < 0.001). Significant risk factors for 365-day mortality included red blood cell transfusion (HR 2.12, 95% CI 1.29–3.49, p = 0.003), higher Charlson Comorbidity Index (HR 9.16, 95% CI 2.22–37.54, p = 0.002), and greater disease complexity (HR 2.35, 95% CI 1.63–3.39, p < 0.001). The single-center, retrospective design limits the generalizability of these findings.

Conclusions

In this cohort of elderly patients with substantial comorbidity, early surgical intervention, when clinically indicated, was associated with significantly reduced 365-day mortality and readmission rates.