Social and Scientific Systems, Durham, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Social and Scientific Systems, Durham, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Urology. 2019 Jul;129:180-187. doi: 10.1016/j.urology.2019.04.012. Epub 2019 Apr 18.
To examine the recent epidemiology of pediatric urinary stone disease (USD) in the United States.
We utilized the 2004-2016 Optum Clinformatics® Data Mart database, a de-identified adjudicated administrative health claims database that includes 15-18 million individuals covered annually by commercial insurance in all 50 US states. The analysis included 12,739,125 children aged 0-18 years. We calculated annual rates of USD, ambulatory visits, and procedures, and the prevalence of prescription fills.
The 2005-2016 USD rate was 59.5 cases per 100,000 person-years. The annual rate rose gradually from 2005 to a peak of 65.2 cases per 100,000 person-years in 2011. The USD rate increased with increasing age, and was highest among females compared to males, non-Hispanic Whites compared to other race/ethnic groups, and those residing in the South compared to other geographic regions. The overall 2005-2016 rate in the 120 days following a USD episode was 1.9 for ambulatory visits, 0.24 for surgical procedures, and 1.1 for imaging procedures. Ureteroscopy was the most common surgical procedure and CT scan was the most common imaging procedures, although ultrasound utilization increased over time. Medications were filled in 46.9% of cases, and use was lowest among males (43.1%), Asians (34.8%), and in the Northeast (34.3%). Opiate agonists were the most prevalent prescription (39.9%).
Our study provides one of the most comprehensive examinations of pediatric USD to date, demonstrating shifting rates and treatment patterns over time, as well as differences by age, gender, race/ethnicity, and geographic region.
研究美国小儿尿石病（USD）的近期流行病学情况。
我们利用了 2004-2016 年 Optum Clinformatics® Data Mart 数据库，这是一个去识别裁定的行政健康索赔数据库，涵盖了全美 50 个州中每年约 1500-1800 万个人。该分析包括了 12739125 名 0-18 岁的儿童。我们计算了 USD、门诊就诊和手术的年度发病率，以及处方填写的流行率。
2005-2016 年 USD 的发病率为 59.5 例/10 万人年。发病率从 2005 年逐渐上升，到 2011 年达到高峰，为 65.2 例/10 万人年。USD 的发病率随年龄增长而增加，女性高于男性，非西班牙裔白人高于其他种族/族裔群体，南部地区高于其他地理区域。在 USD 发作后的 120 天内，总体的就诊率为 1.9 次，手术率为 0.24 次，影像学检查率为 1.1 次。输尿管镜检查是最常见的手术方法，CT 扫描是最常见的影像学检查方法，尽管超声的使用率随着时间的推移而增加。46.9%的病例开具了药物，男性（43.1%）、亚洲人（34.8%）和东北地区（34.3%）的使用率最低。阿片类激动剂是最常见的处方药物（39.9%）。
我们的研究提供了迄今为止对小儿 USD 最全面的检查之一，展示了随着时间的推移发病率和治疗模式的变化，以及按年龄、性别、种族/族裔和地理区域的差异。
