Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan.
J Urol. 2013 Jun;189(6):2158-63. doi: 10.1016/j.juro.2012.12.105. Epub 2013 Jan 9.
We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database.
This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis.
The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r(2) = 0.86, p = 0.001 and r(2) = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r(2) = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects.
Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis.
我们利用全国性的人口基础数据库调查了台湾上尿路结石病的流行病学。
本研究基于台湾全民健康保险研究数据库，该数据库包含了来自 2272 万参保人的所有医疗理赔数据，几乎涵盖了台湾总人口的 99%。国民健康保险研究数据库的子数据库 2005 年纵向健康保险数据库包含了 1997 年至 2010 年期间从 2005 年参保人名单中随机抽取的 100 万参保人所有医疗理赔数据。为了进行流行病学分析，我们选择了其理赔记录包含上尿路结石病诊断的患者。
调整年龄后，1998 年至 2010 年，上尿路结石病的就诊率从每 10 万人中有 1367 人次降至 1278 人次。在这 13 年期间，女性和所有患者的就诊率呈显著下降趋势（r²=0.86，p=0.001 和 r²=0.52，p=0.005），而男性则呈上升趋势（r²=0.45，p=0.012）。2010 年，男性、女性和所有患者的调整年龄后患病率分别为 9.01%、5.79%和 7.38%。1 年和 5 年的总体复发率分别为 6.12%和 34.71%。男性患者的复发率高于女性。
我们的研究提供了台湾上尿路结石病流行病学的重要信息，有助于量化结石病的负担，并制定降低结石病风险的策略。
