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.