Patterns of urologic emergency visits and hospital admissions: experience of a tertiary care center.

PURPOSE: Based on steady increase in the number of visits in German emergency departments, the present study examined patterns of urologic emergency visits and inpatient hospital admissions at a tertiary care center in Germany.

METHODS

Urologic visits in two selected years (2018 and 2022) to the emergency department were identified. Patient characteristics, time, type and reason for presentation, diagnostic and therapeutic measures were tabulated.

RESULTS

Overall, 2,223 urologic emergency visits were recorded in 2022, and 2,795 in 2018. In 2022 vs. 2018, median age was 54 vs. 50 years, 74 vs. 70% were male, 73 vs. 69% self-referrals, and 16 vs. 19% repeat visits. The majority of visits (55 vs. 60%) took place during on-call time. The most common reasons for presentation were lower-acuity infections (18 vs. 19%), followed by urolithiasis (13 vs. 16%) and displacement or loss of catheters (12 vs. 11%). Inpatient hospital admission rates were 22% in 2022 and 26% in 2018. In 2022 multivariable adjusted subgroup analyses, older age and referral by ambulance services, external hospitals, office-based urologists, and general practitioner were associated with inpatient hospital admission, unlike referral by on-call medical services.

CONCLUSION

Most urologic visits in the two selected years were self-referrals, occurred outside of regular working hours, and did not require hospital admission. The present findings suggest that expanding office-based urologic emergency consultation hours and providing targeted urologic training for on-call medical staff may represent potential strategies for optimizing emergency care pathways. However, the effectiveness and appropriateness of these measures warrant prospective evaluation.