Reference: 2026 | Issue 7 | Vol 12 | Page 51
“The study looked at data from over 8,500 people across 380 hospitals and followed them for 90 days”
One in 10 acute patients with visible haematuria die within three months of presenting at the emergency department (ED), according to new research. The WASHOUT study, presented at the European Association of Urology Congress 2026, also found that around one in four of these patients had an underlying cancer, with the most common being bladder cancer. Attendees at the conference heard that a CT scan or cystoscopy within 48 hours could reduce this risk, and also ensure patients with cancer are diagnosed significantly faster.
Currently, there are no clinical guidelines built on real-world evidence for managing patients presenting to the ED with visible haematuria. Based on global figures, only around half (53%) receive a scan and a third (35%) receive surgery, while others are discharged home or admitted to a ward for observation, according to the researchers.
The Ward AdmiSsion of Haematuria: an Observational mUlticentre sTudy was an international, multicentre, prospective observational study designed to describe the management of patients with unplanned admission to hospital with haematuria under the care of the urology team. Data on demographics, comorbidities, management practices, and outcomes were collected using a standardised case report form and analysed using multilevel linear regression modelling. Primary outcomes included length of stay, while secondary outcomes covered hospitalisation-free survival, mortality, readmission rates at 90 days, and resource use.
Ms Nikita Bhatt, Consultant Urologist at St Vincent’s University Hospital, Dublin, led the research. She said: “This is the largest study exploring how we should treat people who present at A&E (accident and emergency) with blood in their urine. It’s a common problem affecting thousands of people around the world, and these patients are usually very unwell. But, too often, they fall through the gaps because it isn’t obviously tied to a specific disease. Our findings show how important it is that doctors take the necessary steps to identify the cause of the problem.”
The research drew on global data to show that rapid action is critical for better patient outcomes. It looked at data from more than 8,500 people across 380 hospitals around the world and followed their journey for 90 days after arriving at an ED. Investigators stated that a CT scan or cystoscopy within 48 hours of arriving at the ED should determine the most appropriate next steps – such as whether the person should be treated for bladder cancer. Patients who did not receive investigative tests or appropriate treatment were 2.5 per cent more likely to die within the next three months compared to those who did. They also spent more time in hospital and were more likely to be readmitted with the same problem within three months.
For patients with an underlying cancer, those who received investigative tests within the first 48 hours of admission were diagnosed within one day, on average. In contrast, patients who were discharged without investigation faced a significantly longer wait, with diagnosis taking an average of three weeks.
The study forms part of a large international research collaboration aimed at improving outcomes for patients with urological conditions and is expected to inform future clinical guidelines for care.
