University of Central Florida, College of Medicine, Orlando, FL, USA.
Department of Urology, Orlando Health, Orlando, FL, USA.
Int Urol Nephrol. 2024 Jul;56(7):2131-2139. doi: 10.1007/s11255-023-03930-5. Epub 2024 Feb 3.
In the surgical treatment of kidney stones, decreased access to healthcare has been shown to exacerbate stone burden, often requiring more invasive and extensive procedures. The objective of this study is to evaluate the effects of preventative health screening on kidney stone surgical treatment patterns.
We performed a retrospective analysis of data from the Healthcare Cost and Utilization Project (HCUP) Florida state-wide dataset and the PLACES Local Data for Better Health dataset from the Centers of Disease Control and Prevention (CDC). ZIP Code Tabulation Areas (ZCTAs) identified from the PLACES data were merged with the HCUP dataset to create a single dataset of community-level stone outcomes and community health measures. We included adult patients 18 years or older who underwent at least one urologic stone procedure from 2016 to 2020.
128,038 patients from 885 communities were included in the study. Patients underwent an average of 1.42 surgeries (Median = 1.39, SD = 0.16). Increased core preventative screening was associated with increased surgical frequency (Estimate: 0.51, P < 0.001). The low core preventative screening group had a higher prevalence of PNL than SWL while the high core preventative screening group had a low PNL prevalence compared to SWL.
Increased core preventative screenings are associated with less invasive kidney stone surgeries, suggesting that preventative screenings detect stones at an earlier stage.
在肾结石的外科治疗中，医疗保健机会减少已被证明会加重结石负担，通常需要更具侵入性和更广泛的手术。本研究的目的是评估预防性健康筛查对肾结石外科治疗模式的影响。
我们对医疗保健成本和利用项目（HCUP）佛罗里达州全州数据集和疾病控制和预防中心（CDC）的 PLACES 当地数据改善健康数据集的数据进行了回顾性分析。从 PLACES 数据中确定的邮政编码区（ZCTA）与 HCUP 数据集合并，创建了一个社区级结石结果和社区健康措施的单一数据集。我们纳入了 2016 年至 2020 年期间至少接受过一次泌尿科结石手术的 18 岁或以上的成年患者。
研究共纳入了来自 885 个社区的 128038 名患者。患者平均接受了 1.42 次手术（中位数=1.39，标准差=0.16）。核心预防性筛查增加与手术频率增加相关（估计值：0.51，P<0.001）。低核心预防性筛查组的经皮肾镜碎石术（PNL）发生率高于体外冲击波碎石术（SWL），而高核心预防性筛查组的 PNL 发生率低于 SWL。
核心预防性筛查增加与侵入性较低的肾结石手术相关，表明预防性筛查可更早发现结石。
