{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:49Z","timestamp":1787028649177,"version":"build-2736575974"},"reference-count":34,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Gross Hematuria is a relevant cause of admission to the emergency department in the general population and particularly in older adults (\u226580 years). This specific urological symptom is often underestimated and usually associated with benign conditions such as urinary infections or poor hydration. Nevertheless, hematuria could lead to severe acute complications or be the first symptom of urological cancers. Methods: We retrospectively analyzed clinical data from 1169 patients aged \u226580 years consecutively admitted to the emergency department for hematuria. The primary endpoint of the study was to identify risk factors for major complications, and the secondary endpoint was to analyze risk factors for urological cancer diagnosis. The median age was 85 years (IQR 82\u201388 years), and 908 (77%) were males. Among them, 449 (38.4%) had a past medical history of urological neoplasm (kidney, ureter, bladder, prostate, or urethral cancer). Results: Overall, 87 patients (7.4%) had major complications (patient death, septic shock, and admission to the intensive care unit). Worse vital signs at admission, fever, and confusion (p &lt; 0.001, OR 18.0 IC 95% [5.5\u201358.7]; p = 0.015, OR 2.0 IC 95% [1.1\u20133.5]; p = &lt;0.001, OR 4.2 IC 95% [1.9\u20133.5], respectively), as well as lower hemoglobin values and higher Charlson comorbidity index (p &lt; 0.001, OR 0.8 IC 95% [0.7\u20130.9]), p = 0.002, OR = 1.2 [1.1\u20131.3]) were independent predictive factors for major complications. The multivariate analysis identified as risk factors for diagnosis of urological cancer older age, male sex and higher comorbidity (OR 1.05 IC95% [1\u20131.09]; OR 2.19 IC95% [1.42\u20133.39] and OR 1.11 IC95% [1.2\u20131.2], respectively); interestingly the presence of indwelling vesical catheter (IVC) (OR 0.44 IC95% [0.24\u20130.82]) resulted as an independent factor for absence of urological cancers. Conclusions: Hematuria is a frequent symptom in older adults admitted to the emergency department. While this is often associated with benign conditions, there are some risk factors for major complications and for urological cancer that must be taken into account to identify the patients who need further evaluation or prompt hospital admission.<\/jats:p>","DOI":"10.3390\/jcm13102874","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:18:17Z","timestamp":1715599097000},"page":"2874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictive Factors for Major Complications and Urological Cancer Diagnosis in Older Adults (\u226580 Years) Admitted to the Emergency Department for Hematuria"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-8729","authenticated-orcid":false,"given":"Mauro","family":"Ragonese","sequence":"first","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1799-3865","authenticated-orcid":false,"given":"Daniele","family":"Fettucciari","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Carbone","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Ospedale Fatebenefratelli Isola Tiberina, Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9994-4316","authenticated-orcid":false,"given":"Filippo","family":"Gavi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Montesi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eros","family":"Scarciglia","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-9486","authenticated-orcid":false,"given":"Pierluigi","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Maria","family":"Sanesi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2908-6907","authenticated-orcid":false,"given":"Filippo","family":"Marino","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0464-0788","authenticated-orcid":false,"given":"Nazario","family":"Foschi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Franceschi","sequence":"additional","affiliation":[{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"},{"name":"Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-8479","authenticated-orcid":false,"given":"Marco","family":"Racioppi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy"},{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-8354","authenticated-orcid":false,"given":"Emilio","family":"Sacco","sequence":"additional","affiliation":[{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"},{"name":"Department of Urology, Ospedale Fatebenefratelli Isola Tiberina, Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6709-2531","authenticated-orcid":false,"given":"Marcello","family":"Covino","sequence":"additional","affiliation":[{"name":"Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, 00136 Rome, Italy"},{"name":"Emergency Medicine, Fondazione Policlinico Universitario A. 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