Emergency Department Visits for Pelvic Organ Prolapse in the United States.

Abstract

Importance: Little is known regarding patient use of the emergency department for prolapse symptoms and the burden this use places on the health care system.

Objective: The aim of the study was to evaluate the incidence of emergency department visits in the United States for pelvic organ prolapse and associated patient and hospital demographics.

Study design: This was a cross-sectional study of emergency department presentations from 2016 to 2018 associated with a primary diagnosis of pelvic organ prolapse. Data were obtained using International Classification of Diseases, Tenth Revision, Clinical Modification codes from the Healthcare Cost and Utilization Project Nationwide Emergency Department Samples. Descriptive analysis was used to identify sociodemographic and clinical characteristics of the population presenting to the emergency department for prolapse.

Results: Between 2016 and 2018, there were 14,101 annual emergency department visits for prolapse in the United States, which comprised less than 0.01% of all emergency department visits. Overall, 55.5% of patients were <65 years old and 62.5% had a household income of <50th percentile ($0-$58,999). The most common secondary diagnosis was hypertension (12.3%), and the most common secondary urogynecologic diagnosis was urinary tract infection or pyelonephritis (5.7%). No high-risk comorbidities were seen in 78.1% of patients. Most patients with prolapse were discharged (91.8%), although 5.8% were admitted and 1.5% were transferred for further care.

Conclusions: Emergency department presentation for pelvic organ prolapse is uncommon. Disproportionate emergency department use was seen for patients <65 years old and with low household income. Further initiatives can optimize outpatient workflows for urogynecologic care and expand community outreach efforts on prolapse education to reduce emergency department use for nonurgent concerns.