Einstein Healthcare Network, Department of Urology, Philadelphia, PA.
Einstein Healthcare Network, Department of Biostatistics, Philadelphia, PA.
Urology. 2020 Aug;142:65-69. doi: 10.1016/j.urology.2020.03.047. Epub 2020 Apr 17.
To identify how demographic factors, stone-associated medical comorbidities, and treatment predict compliance with 24-hour urine collection.
A retrospective medical record review of patients treated for urolithiasis between August 2014 and March 2017 was performed. Patient demographics, medical characteristics, stone factors, type of treatment, and compliance data were included for patients requested to submit a collection. Variables that were statistically significant on bivariate analysis were then used to formulate a model predicting submission of a 24-hour urine sample.
Of the 303 patients who met inclusion criteria, 183 (60.4%) submitted an initial 24-hour urine collection. On bivariate analysis, patients older than 50 were more likely to submit a 24-hour urine collection (71.4% vs 51.5%; P <.001), patients with a metabolic predisposition for stones were more likely to submit a 24-hour urine collection (70.6% vs 53.1%; P <.003), and patients who did not have surgery were more likely to submit a 24-hour urine collection (97.9% vs 53.5%; P <.001). Our 3-variable prediction model found that not undergoing surgery was a strong predictor of 24-hour urine collection.
We suspect that patients perceive surgery as a more definitive treatment for kidney stones than conservative management. Patient education on the natural history and role of metabolic management in the prevention of nephrolithiasis is essential in improving compliance with 24-hour urine collection.
确定人口统计学因素、与结石相关的合并症和治疗方法如何预测对 24 小时尿液收集的依从性。
对 2014 年 8 月至 2017 年 3 月期间接受尿路结石治疗的患者进行了回顾性病历审查。纳入了患者的人口统计学特征、医疗特征、结石因素、治疗类型和收集依从性数据。对单变量分析有统计学意义的变量,然后用于构建预测 24 小时尿液样本提交的模型。
在符合纳入标准的 303 名患者中,有 183 名(60.4%)提交了初始 24 小时尿液收集。在单变量分析中,年龄大于 50 岁的患者更有可能提交 24 小时尿液收集(71.4%比 51.5%;P<.001),有结石代谢倾向的患者更有可能提交 24 小时尿液收集(70.6%比 53.1%;P<.003),未接受手术的患者更有可能提交 24 小时尿液收集(97.9%比 53.5%;P<.001)。我们的三变量预测模型发现,未接受手术是 24 小时尿液收集的强烈预测因素。
我们怀疑患者认为手术比保守治疗更能彻底治疗肾结石。对患者进行有关肾结石自然史和代谢管理在预防肾结石中的作用的教育对于提高 24 小时尿液收集的依从性至关重要。