Ward AdmiSsion of Haematuria, an Observational mUlticentre sTudy: patient-level analysis (WASHOUT)
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Authors
Byrnes K.
Bhatt N.
Khadhouri S.
Cullivan O.
O'Kelly J.
Mares J.
Keane K.
Ahmed U.
Crone L.
Gallagher K.
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2025
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Article
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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.
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Eu Uro Op Sci.
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10