Clot Retention and Advanced Age as Predictors of Intervention in Patients Presenting With Gross Hematuria: A Retrospective Cohort Study.

Background and objective Gross hematuria is a common urologic manifestation that often requires hospitalization and immediate evaluation. Early identification of factors associated with the need for intervention can aid in risk stratification and guide timely clinical management. The objective of this study was to evaluate hospitalized patients with gross hematuria and identify predictors associated with the need for intervention. Methods This retrospective cohort study included adult patients admitted with gross hematuria between January 2023 and December 2025 at Prince Hussein Urology Center, Amman, Jordan, affiliated with the Royal Medical Services. Data were obtained from the Hakeem electronic medical record system. A total of 330 patients were included and categorized into an intervention group (n = 99; 30%) and a nonintervention group (n = 231; 70%). Univariable analysis followed by multivariable logistic regression was performed to identify predictors of intervention. A p-value < 0.05 was considered statistically significant. Results Among 330 patients admitted with gross hematuria, 99 (30.0%) required urologic intervention. Patients requiring intervention were older (mean age, 66.8 ± 14.9 years) and more frequently had clot retention, anemia, and elevated serum creatinine levels. Bladder tumor was the most common etiology, accounting for 39.4% of cases in the intervention group. On multivariable analysis, clot retention (OR, 4.11; 95% CI, 2.23-7.59; p < 0.001) and increasing age (OR, 1.02; 95% CI, 1.00-1.04; p = 0.028) were independently associated with the need for urologic intervention after multivariable adjustment. Conclusions Clot retention and advancing age are independent predictors of urologic intervention in patients admitted with gross hematuria. Early recognition of these factors may help guide risk stratification and facilitate timely management.