Effect of age on the clinical presentation of incident symptomatic urolithiasis in the general population.
Effect of age on the clinical presentation of incident symptomatic urolithiasis in the general population.
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DOI：
10.1016/j.juro.2012.09.023
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发表时间：
2013-01
影响因子：
6.6
通讯作者：
Rule, Andrew D.
中科院分区：
文献类型：
--
作者：
Krambeck, Amy E.;Lieske, John C.;Li, Xujian;Bergstralh, Eric J.;Melton, L. Joseph, III;Rule, Andrew D.
我们描述了一般人群中年龄较大和年龄较小的首次症状性结石形成者之间临床表现的差异。我们研究了1984年至2003年期间明尼苏达州奥姆斯特德县居民的第一个尿石症诊断代码的随机样本。图表确认有症状的结石形成者通过成像或结石通过确认了结石。比较不同年龄组的临床表现特征。在审查的3，473份图表中，有1，590例经确认的事件症状性结石形成者（平均年龄43岁，范围18至96岁）。老年人更可能出现非典型或无疼痛、发热、腹泻、脓尿、尿路感染和菌血症（p <0.001）。结石的大小和位置不因患者年龄而异。磷酸钙结石病与年轻有关，而尿酸结石和非典型结石成分与老年有关（p <0.001）。老年人不太可能自发排出结石，更可能需要手术干预（p <0.001）。516例（32.5%）患者需要手术干预。年轻人更有可能接受输尿管镜检查，而老年人更有可能接受冲击波碎石术，延迟支架置入术和经皮肾镜取石术。由于非典型疼痛或无疼痛，以及存在其他合并症，如尿路感染和腹泻，老年人结石病的检测可能具有挑战性。老年人可能需要更高的尿石症怀疑指数，以便更及时地诊断和干预，以防止发病。
We characterized variation in the clinical presentation between older and younger first time symptomatic stone formers in the general population. We studied a random sample of Olmsted County, Minnesota residents with their first diagnostic code for urolithiasis between 1984 and 2003. Chart validated symptomatic stone formers had a confirmed stone by imaging or stone passage. Clinical presentation characteristics were compared between age groups. Among the 3,473 charts reviewed there were 1,590 validated incident symptomatic stone formers (mean age 43 years, range 18 to 96). Older individuals were more likely to present with atypical or no pain, fever, diarrhea, pyuria, urinary tract infections and bacteremia (p <0.001). Stone size and location did not differ by patient age. Calcium phosphate stone disease was associated with younger age, while uric acid stone and atypical stone composition was associated with older age (p <0.001). Older individuals were less likely to pass the stone spontaneously and were more likely to require surgical intervention (p <0.001). Surgical intervention was required in 516 (32.5%) individuals. Younger individuals were more likely to undergo ureteroscopy while older individuals were more likely to undergo shock wave lithotripsy, temporizing stent placement and percutaneous nephrolithotomy. The detection of stone disease in older individuals can be challenging due to atypical pain or absence of pain, as well as the presence of other comorbid conditions such as urinary tract infections and diarrhea. A higher index of suspicion for urolithiasis may be needed in the elderly for a more timely diagnosis and intervention to prevent morbidity.
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影响因子：
5
作者：
HIATT, RA;DALES, LG;HUNKELER, EM
通讯作者：
HUNKELER, EM
DOI：
10.1111/j.1464-410x.1987.tb09123.x
发表时间：
1987-07-01
期刊：
BRITISH JOURNAL OF UROLOGY
影响因子：
--
作者：
LJUNGHALL, S;LITHELL, H;SKARFORS, E
通讯作者：
SKARFORS, E
影响因子：
6.6
作者：
Gentle, DL;Stoller, ML;Leslie, SW
通讯作者：
Leslie, SW
影响因子：
1.6
作者：
YOSHIDA, O;OKADA, Y
通讯作者：
OKADA, Y
影响因子：
6.6
作者：
PIERRATOS, AE;KHALAFF, H;JEWETT, MAS
通讯作者：
JEWETT, MAS