当前位置： SCI文献检索 > Journal of Pediatric Urology期刊下所有文献 > Risk factors for repeat surgical intervention in pediatric nephrolithiasis: A Pediatric Health Information System database study.

Risk factors for repeat surgical intervention in pediatric nephrolithiasis: A Pediatric Health Information System database study.

Abstract：

INTRODUCTION:Successful surgical therapy for pediatric upper urinary tract calculi (UUTC) minimizes the need for repeat surgical interventions. However, staged procedures, whether planned or unplanned, are sometimes necessary. We assessed predictors of repeat intervention for children with UUTC using a nationwide administrative dataset. METHODS:Using the Pediatric Health Information System (PHIS) dataset, we assessed children with UUTC undergoing shock wave lithotripsy (SWL) or ureteroscopy (URS) for an index stone from January 2010 to June 2015. Primary outcome was additional treatment for nephrolithiasis within 90 days. Patient and procedural variables were assessed as potential risks for retreatment. Multivariable logistic regression models were used to compare the risk of retreatment adjusting for potential confounding factors. RESULTS:A total of 2788 patients undergoing URS (2,216, 79.5%) and SWL (572, 20.5%) were identified. SWL, stenting at the index operation without pre-index stenting, chronic comorbidities, renal calculi, and age <5 years were independent risk factors for retreatment. Use of ureteral stenting, most commonly employed in URS, was also a strong predictor of retreatment. Odds for reintervention, adjusted by multivariate modeling, are shown in the Figure. CONCLUSIONS:Adjusting for measured confounders, SWL is associated with a 2.6-fold higher risk of repeat stone-related interventions. Additional patient-related factors also increase likelihood of retreatment. Intra-operative stent placement is a strong predictor of retreatment, perhaps serving as a marker for complex cases or planned staged procedures. Prospective studies are needed to assess comparative effectiveness of SWL and URS and improve mono-therapeutic success for children with UUTC.

journal_name

J Pediatr Urol

journal_title

Journal of pediatric urology

authors

Ellison JS,Shnorhavorian M,Oron A,Kieran K,Lendvay TS,Merguerian PA

doi

10.1016/j.jpurol.2018.02.017

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

245.e1-245.e6

issue

eissn

1477-5131

issn

1873-4898

pii

S1477-5131(18)30109-8

journal_volume

pub_type

杂志文章,多中心研究

在线工具

Risk factors for repeat surgical intervention in pediatric nephrolithiasis: A Pediatric Health Information System database study.