Infected hydronephrosis: Can we reduce patient suffering and costs?

Objective: to investigate the correlation among clinical parameters,risk factors,outcomes and costs in the context of patients with infected hydronephrosis. methods: this retrospective,multi-centric study was conducted in three romanian academic urology departments,and comprised data of patients with infected hydronephrosis treated between july 2013 and july 2014. based on per-patient hospitalisation costs,the participants were divided into three groups: group a: cost less than 500 euros),group b: between 500 and 1,000 euros,and group c: over 1,000 euros). differences between clinical parameters,comorbidities,type of procedure,admission to intensive care unit,length of hospital stay and costs were analysed. results: of the 175 patients,49(28%) were in group a,95(54.3%) in group b and 31(17.7%) in group c. the relevant parameters influencing outcomes and costs were age (p=0.001),neoplasical aetiology (p=0.001),leukocytosis (p=0.001),renal insufficiency (p=0.001),and moment of the intervention (p=0.005). diabetes did not influence the costs (p=0.36). jj stent insertion was tolerated at least the same as percutaneous nephrostomy,and with the same efficiency. conclusion: in order to avoid patient suffering and to reduce costs linked to the treatment of infected hydronephrosis,the patient-general practitioner-specialist collaboration is of the utmost importance. symptoms,signs,paraclinical features and empirical use of antibiotics may all lead to a delay in proper management,thus making the hospitalisation longer and the costs significantly higher. © 2016,pakistan medical association. all rights reserved.