A population-based retrospective cohort study analyzing contemporary trends in the surgical management of urinary stone disease in adults

Introduction: We aimed to review the trends and incidence of surgical intervention for adults with upper urinary tract stones in Ontario, Canada, and to hypothesize potential causes for the observed changes. Methods: We carried out a retrospective, population-based cohort study using administrative databases held at the Institute of Clinical Evaluative Sciences (IC/ES) to identify all adults (≥18 years) who underwent surgical treatment for urolithiasis, defined by records using a combination of both hospital and physician billing from 2002–2019. Descriptive statistics were used to summarize baseline patient demographics, and surgical trends were analyzed using the Cochrane-Armitage test for trend. Results: From 2002–2019, 140 263 patients were treated surgically for urolithiasis. During this time period, the total number of surgically treated stone disease increased by 80.5%. By type of procedure, percutaneous nephrolithotomy (PCNL) increased by 187% and ureteroscopy (URS) increased by 158%, while the number of shockwave lithotripsy (SWL) declined by 31.4%. The adult population in Ontario in the years evaluated grew by 24.4%. The number of surgical procedures per 100 000 people over this time grew by 45.3%. For every 1% increase in the population, there was a 2.6% rise in stone-related surgical procedures. Conclusions: The number of stone-related surgical procedures performed rose significantly and cannot be accounted for by population growth alone. This rise was proportionally larger in the female population, further supporting a narrowing of the gender gap in urinary stone disease. The reasons for the increase are likely multifactorial and may imply an increasing incidence of surgically treated stone disease. The change in the proportion of URS and SWL performed may demonstrate a continued shift in surgical preference or may be reflective of resource limitations and availability. The increase in PCNL volumes may also suggest a greater complexity of cases. These findings should be considered for future resource planning and require further study.

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Increased Risk of Acute Coronary Syndrome among Patients with Urinary Stone Disease: A Nationwide Population-Based Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0102349 ◽

2014 ◽

Vol 9 (7) ◽

pp. e102349

Author(s):

Shun-Fa Hung ◽

Chao-Yuan Huang ◽

Cheng-Li Lin ◽

Shiu-Dong Chung ◽

Chi-Jung Chung ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Population Based ◽

Urinary Stone ◽

Stone Disease ◽

Urinary Stone Disease ◽

Coronary Syndrome ◽

Increased Risk

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Recent surgical treatments for urinary stone disease in a Korean population: National population‐based study

International Journal of Urology ◽

10.1111/iju.13928 ◽

2019 ◽

Vol 26 (5) ◽

pp. 558-564 ◽

Cited By ~ 2

Author(s):

Jong Keun Kim ◽

Young Sam Cho ◽

Sung Yul Park ◽

Kwan Joong Joo ◽

Seung Ki Min ◽

...

Keyword(s):

Population Based ◽

Urinary Stone ◽

Stone Disease ◽

Korean Population ◽

Population Based Study ◽

Urinary Stone Disease ◽

National Population ◽

Surgical Treatments

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Risk factors for urinary stone

Journal of Korean Medical Association ◽

10.5124/jkma.2020.63.11.660 ◽

2020 ◽

Vol 63 (11) ◽

pp. 660-667

Author(s):

Kyung-Jin Oh

Keyword(s):

Risk Factors ◽

Gender Gap ◽

Metabolic Diseases ◽

Stone Formation ◽

Population Based ◽

Urinary Stone ◽

Stone Disease ◽

Dietary Factors ◽

Male Predominance ◽

Urologic Diseases

Urolithiasis is one of the most common urologic diseases in Korea. The annual incidence of urolithiasis in Korea has increased over time. Understanding the epidemiology and risk factors for urolithiasis is essential for patient care and prevention. The purpose of this review was to summarize the recent literature regarding the risk factors for urolithiasis. The available Korean-population-based trials were enrolled in this study. The peak incidence age was the fifth to sixth decades in Korea. There has been a persistent male predominance in the prevalence and incidence of stone disease. The gender gap has continuously narrowed over the world. Climate and seasonal variations, such as temperature and humidity, have a profound effect on the development of urolithiasis. Various dietary factors, including calcium, sodium, animal protein, and oxalate, play an important role in the development of urolithiasis. Dehydration is a wellknown risk factor for stone disease. Many metabolic diseases can affect urolithiasis, including obesity, hypertension, diabetes, gout, and metabolic syndrome. The fast-moving super-aged society and global warming can increase stone disease burden in the near future. To prevent and reduce stone diseases, clinicians should understand the risk factors affecting stone formation.

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An Initial Attack of Urinary Stone Disease Is Associated with an Increased Risk of Developing New-Onset Irritable Bowel Syndrome: Nationwide Population-Based Study

PLoS ONE ◽

10.1371/journal.pone.0157701 ◽

2016 ◽

Vol 11 (6) ◽

pp. e0157701 ◽

Cited By ~ 4

Author(s):

Wei-Yuan Lei ◽

Chih-Yu Chang ◽

Jr-Hau Wu ◽

Fei-Hung Lin ◽

Cheng Hsu Chen ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Population Based ◽

Urinary Stone ◽

Stone Disease ◽

Initial Attack ◽

Population Based Study ◽

Urinary Stone Disease ◽

Increased Risk ◽

Irritable Bowel ◽

New Onset

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Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

Acta Endocrinologica ◽

10.1530/eje-20-0628 ◽

2021 ◽

Vol 184 (1) ◽

pp. 19-28

Author(s):

Alexander A Leung ◽

Janice L Pasieka ◽

Martin D Hyrcza ◽

Danièle Pacaud ◽

Yuan Dong ◽

...

Keyword(s):

Cohort Study ◽

Administrative Data ◽

Laboratory Data ◽

Population Based ◽

Incidence Rates ◽

Primary Objective ◽

Administrative Databases ◽

Secondary Objective ◽

True Frequency ◽

Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

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