The Association Between 24-Hour Urine and Stone Recurrence Among High Risk Kidney Stone Formers: A Population Level Assessment
The Association Between 24-Hour Urine and Stone Recurrence Among High Risk Kidney Stone Formers: A Population Level Assessment
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DOI：
10.1016/j.urology.2020.05.064
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发表时间：
2020-10-01
期刊：
影响因子：
2.1
通讯作者：
Harper, Jonathan D.
中科院分区：
文献类型：
--
作者：
Samson, Patrick C.;Holt, Sarah K.;Harper, Jonathan D.
目的为了确定是否获得24小时尿液收集（24 HU）在结石形成者与减少复发性结石epissions.METHODS使用MarketScan数据库，成人17-62岁肾结石被确定在2007年和2017年之间，至少3年的随访。高风险结石形成者、接受结石手术者和有复发结石史者被识别出来。初步诊断后6个月内的暴露量为24 HU。结果是结石复发，定义为诊断后90天至3年内与结石相关的急诊室就诊、住院或结石手术。Logistic回归分析被用来估计24 HU暴露的复发风险，整个队列和子队列仅限于已知的复发性结石形成者，高风险的科目，和那些有结石surgery. Results的434，055受试者分析，30，153（6.9%）有24 HU。24 HU利用率每年下降（7.5%-5.8%）。还观察到使用率的区域差异。在多变量分析中，完成24 HU与以下任何队列的复发风险无关：（OR 0.98，95% CI 0.9-1.07），高风险和复发性结石患者（OR 0.95 [0.8-1.13]），接受手术的患者（OR 1.02 [0.97-1.07]）;在那些被标记为高风险的患者中，24 HU与复发呈正相关，结论24 HU与总体人群和高危亚组复发率的降低无关。泌尿学144：71-76，2020年。(c)2020爱思唯尔公司
OBJECTIVE To determine if obtaining a 24-hour urine collection (24HU) in stone formers is associated with decreased recurrent stone episodes.METHODS Using the MarketScan database, adults 17-62 years old with nephrolithiasis were identified between 2007 and 2017 with a minimum of 3-year follow up. High-risk stone formers, those undergoing stone surgery, and those with history of recurrent stones were identified. The exposure was a 24HU within 6 months of primary diagnosis. The outcome was recurrent stone episodes-defined by stone-related emergency room visits, hospitalizations, or stone surgery 90 days to 3 years after diagnosis. Logistic regression was used to estimate recurrence risk by 24HU exposure for the overall cohort and sub-cohorts limited to known recurrent stone formers, high-risk subjects, and those having stone surgery.RESULTS Of 434,055 subjects analyzed, 30,153 (6.9%) had a 24HU. An annual decline in 24HU utilization was seen (7.5%-5.8%). Regional variation in usage rate was also observed. On multivariate analysis, completing a 24HU was not associated with risk of recurrence in any of the following cohorts: recurrent stone formers (OR 0.98, 95% CI 0.9-1.07), both high risk and recurrent stone formers (OR 0.95 [0.8-1.13]), those undergoing surgery (OR 1.02 [0.97-1.07]); a positive association with 24HU and recurrence was seen in those labeled high-risk (OR 1.08 [1.01-1.16]) and in all-comers (OR 1.15 [1.12-1.19]).CONCLUSION The 24HU was not associated with decreased recurrence rates in the overall population nor in higher risk sub-cohorts. UROLOGY 144: 71-76, 2020. (c) 2020 Elsevier Inc.