Burden, management and outcomes of emergency haematuria admissions: a 9-month retrospective cohort study

Background Visible haematuria accounts for approximately 15% of urological emergency admissions, yet standardised inpatient management protocols are absent. This study aimed to define the burden, aetiology, management requirements, and predictors of adverse clinical outcomes in emergency haematuria admissions at a tertiary Irish urology centre. Methods A single-centre retrospective observational cohort study was conducted across all emergency haematuria admissions from July 2025 to March 2026. Data were extracted from prospective clinical handover records and cross-referenced with electronic patient records. Primary outcomes were length of stay (LOS), theatre intervention, transfusion requirement, and unplanned readmission. Results Sixty-three admissions were identified across 50 unique patients. Median age was 81 years (IQR 73–85); 87% were male. Benign prostatic hyperplasia (BPH) and radiation cystitis each accounted for 27% of admissions, followed by post-operative haematuria (21%) and malignancy (19%). Sixty-eight percent of patients were on anticoagulant or antiplatelet therapy. Theatre intervention was required in 43% of admissions; radiation cystitis carried the highest transfusion rate (35%). Theatre intervention and transfusion requirement were independently associated with significantly longer LOS (median 6 vs 4 days, p = 0.002; 12 vs 4 days, p < 0.001 respectively). The readmission rate was 26%, with malignancy the only significant independent predictor (OR 4.71, p = 0.046). Anticoagulant type was not a significant predictor of any adverse outcome. Conclusion Emergency haematuria admissions represent a high-acuity workload predominantly affecting elderly, antithrombotic-treated patients. Malignancy predicts readmission and radiation cystitis drives transfusion burden. These findings support risk-stratified admission pathways incorporating early malignancy triage and haemoglobin-guided decision-making.