Kan Kathleen M, Agrawal Gunjan, Brosula Raphael, Venkatapuram Pranaya, Chen Abby L, Zhang Chiyuan A
Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Urology 5656, Palo Alto, CA, 94304, USA.
Flushing Hospital Medical Center, 4500 Parsons Blvd, Flushing, NY, 11533, USA.
Int Urol Nephrol. 2024 Jun;56(6):1785-1793. doi: 10.1007/s11255-023-03913-6. Epub 2024 Jan 30.
We conducted this study to estimate the prevalence of pediatric lower urinary tract symptoms (pLUTS) in a US privately insured pediatric population who are 6-20 years old by age, sex, race/ethnicity from 2003-2014. This has not been previously described in the literature.
We retrospectively reviewed Optum's de-identified Clinformatics® Data Mart Database between 2003-2014. A pLUTS patient was defined by the presence of ≥ 1 pLUTS-related ICD-9 diagnosis code between the age of 6-20 years. Neurogenic bladder, renal transplant and structural urologic disease diagnoses were excluded. Prevalence by year was calculated as a proportion of pLUTS patients among the total population at risk. Variables reviewed included age, sex, race, geographic region, household factors and clinical comorbidities including attention-deficit/hyperactivity disorder (ADHD), constipation, and sleep apnea. Point of service (POS) was calculated as a proportion of pLUTS-related claims associated with a POS compared to the total claims at all POS in the time period.
We identified 282,427 unique patients with ≥ 1 claim for pLUTS between the ages of 6-20 years from 2003 to 2014. Average prevalence during this period was 0.92%, increasing from 0.63% in 2003 to 1.13% in 2014. The median age group of patients was 6-10 years. More patients were female (59.80%), white (65.97%), between 6 and 10 years old (52.18%) and resided in the Southern US (44.97%). Within a single household, 81.71% reported ≤ 2 children, and 65.53% reported ≥ 3 adults. 16.88% had a diagnosis of ADHD, 19.49% had a diagnosis of constipation and 3.04% had a diagnosis of sleep apnea. 75% of pLUTS-related claims were recorded in an outpatient setting.
Families consistently seek medical care in the outpatient setting for pLUTS. The demographic and clinical characteristics of our cohort reflect prior literature. Future studies can help define temporal relationships between household factors and onset of disease as well as characterize pLUTS-related healthcare resource utilization. Additional work is required in publicly insured populations.
我们开展这项研究，旨在估计2003年至2014年期间，美国6至20岁参加私人保险的儿科人群中，按年龄、性别、种族/族裔划分的小儿下尿路症状（pLUTS）的患病率。此前文献中尚未对此进行描述。
我们回顾性分析了Optum公司2003年至2014年期间经过去识别处理的临床信息学数据集市数据库。pLUTS患者定义为在6至20岁之间出现≥1个与pLUTS相关的国际疾病分类第九版（ICD-9）诊断代码的患者。排除神经源性膀胱、肾移植和结构性泌尿系统疾病的诊断。按年份计算患病率，即pLUTS患者在总风险人群中所占的比例。所审查的变量包括年龄、性别、种族、地理区域、家庭因素以及临床合并症，包括注意力缺陷多动障碍（ADHD）、便秘和睡眠呼吸暂停。服务点（POS）计算为与某一服务点相关的pLUTS相关索赔占该时间段内所有服务点总索赔的比例。
我们识别出282,427名在2003年至2014年期间年龄在6至20岁之间、有≥1次pLUTS索赔的独特患者。在此期间的平均患病率为0.92%，从2003年的0.63%增至2014年的1.13%。患者的年龄中位数组为6至10岁。女性患者更多（59.80%），白人患者更多（65.97%），年龄在6至10岁之间的患者更多（52.18%），且居住在美国南部的患者更多（44.97%）。在单个家庭中，81.71%的家庭报告有≤2名儿童，65.53%的家庭报告有≥3名成年人。16.88%的患者被诊断为ADHD，19.49%的患者被诊断为便秘，3.04%的患者被诊断为睡眠呼吸暂停。75%的pLUTS相关索赔记录在门诊环境中。
家庭一直会因pLUTS在门诊环境中寻求医疗护理。我们队列的人口统计学和临床特征反映了先前的文献。未来的研究有助于确定家庭因素与疾病发作之间的时间关系，以及描述与pLUTS相关的医疗资源利用情况。在参加公共保险的人群中还需要开展更多工作。
