Ward AdmiSsion of Haematuria, an Observational mUlticentre sTudy: patient-level analysis (WASHOUT)
No Thumbnail Available
Authors
Byrnes K.
Bhatt N.
Khadhouri S.
Cullivan O.
O'Kelly J.
Mares J.
Keane K.
Ahmed U.
Crone L.
Gallagher K.
Contact
Check for full-text access
Issue Date
2025
Type
Article
Language
Keywords
Alternative Title
Abstract
Introduction: No evidence-based guideline recommendations exist on inpatient management of haematuria in secondary care. A systematic review (CRD42023466710) found no large-scale prospective studies have been performed. This study aims to address these gaps by investigating current practice in secondary care. Method(s): Preliminary analysis on a prospective, international multicentre observational study was performed, recruiting a general cohort of unscheduled admissions for haematuria. Recruitment opened from 1<sup>st</sup> January 2024 for a 2-year period. Result(s): 375 sites across 56 countries contributed 5749 patients, including 6 Irish centres contributing 181 cases. Length of stay (mean +/- SD) was 6.74 +/- 9.05d (re-admission rate 15% at 90d). Median age was 75 (IQR 64-83) and 83.9% were male. Patients in the cohort were frequently frail (46.6% with CFS>=5), co-morbid (CCI 5 +/- 3.1) and on anti-coagulants (43.6%). Mortality at 90 days follow-up was 13.6% (2.3% during index admission). 43.6% of patients were on anticoagulation (withheld during admission in 82.5%). Thromboembolic events occurred in 3.7% at 90 days (1.2% during index admission). 50.4% had inpatient imaging, 34.2% had intervention (time to imaging 1.84 +/- 11.1; time to intervention (4.11 +/- 5.43 days). 48.7% had benign causes, 12.5% postoperative and 38.8% malignant(of which 23.5% were diagnosed with metastatic disease at 90d follow-up vs. 12% during index admission). Tertiary referral centres had effective early management (62.5% vs. 37%; p < .001), as did combined acute/elective sites (78.1% vs 21.8%; p <.001). Conclusion(s): Findings highlight adverse outcomes in this patient cohort, with wide variation in practice. Implementation of standardised management pathways in secondary care may reduce variability and improve outcomes. Copyright © 2025 European Association of Urology. Published by Elsevier B.V.
Description
Citation
Publisher
License
Journal
Eu Uro Op Sci.
Volume
Issue
10