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A Comparative Study of Stone Re-Treatment after Lithotripsy

The high recurrence rate has always been a problem associated with urolithiasis. This study aimed to explore the effectiveness of single interventions, combined therapies, and surgical and nonsurgical interventions. Herein, three lithotripsy procedures—extracorporeal shock wave lithotripsy (ESWL), p...

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Autores principales: Chiou, Yueh-Er, Chung, Chi-Hsiang, Chien, Wu-Chien, Tsay, Pei-Kwei, Kan, Hung-Cheng, Weng, Wen-Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780782/
https://www.ncbi.nlm.nih.gov/pubmed/36556495
http://dx.doi.org/10.3390/life12122130
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author Chiou, Yueh-Er
Chung, Chi-Hsiang
Chien, Wu-Chien
Tsay, Pei-Kwei
Kan, Hung-Cheng
Weng, Wen-Hui
author_facet Chiou, Yueh-Er
Chung, Chi-Hsiang
Chien, Wu-Chien
Tsay, Pei-Kwei
Kan, Hung-Cheng
Weng, Wen-Hui
author_sort Chiou, Yueh-Er
collection PubMed
description The high recurrence rate has always been a problem associated with urolithiasis. This study aimed to explore the effectiveness of single interventions, combined therapies, and surgical and nonsurgical interventions. Herein, three lithotripsy procedures—extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic lithotripsy (URSL)—were assessed and a retrospective cohort was selected in order to further analyze the association with several risk factors. Firstly, a population-based cohort from the Taiwan National Health Insurance Research Database (NHIRD) from 1997 to 2010 was selected. In this study, 350 lithotripsy patients who underwent re-treatment were followed up for at least six years to compare re-treatment rates, with 1400 patients without any lithotripsy treatment being used as the comparison cohort. A Cox proportional hazards regression model was applied. Our results indicate that the risk of repeat urolithiasis treatment was 1.71-fold higher in patients that received lithotripsy when compared to patients that were not treated with lithotripsy (hazard ratio (HR) 1.71; 95% confidence interval (CI) = 1.427–2.048; p < 0.001). Furthermore, a high percentage of repeated treatment was observed in the ESWL group (HR 1.60; 95% CI = 1.292–1.978; p < 0.001). Similarly, the PCNL group was also independently associated with a high chance of repeated treatment (HR 2.32; 95% CI = 1.616–3.329; p < 0.001). Furthermore, age, season, level of care, and Charlson comorbidities index (CCI) should always be taken into consideration as effect factors that are highly correlated with repeated treatment rates.
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spelling pubmed-97807822022-12-24 A Comparative Study of Stone Re-Treatment after Lithotripsy Chiou, Yueh-Er Chung, Chi-Hsiang Chien, Wu-Chien Tsay, Pei-Kwei Kan, Hung-Cheng Weng, Wen-Hui Life (Basel) Article The high recurrence rate has always been a problem associated with urolithiasis. This study aimed to explore the effectiveness of single interventions, combined therapies, and surgical and nonsurgical interventions. Herein, three lithotripsy procedures—extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), and ureteroscopic lithotripsy (URSL)—were assessed and a retrospective cohort was selected in order to further analyze the association with several risk factors. Firstly, a population-based cohort from the Taiwan National Health Insurance Research Database (NHIRD) from 1997 to 2010 was selected. In this study, 350 lithotripsy patients who underwent re-treatment were followed up for at least six years to compare re-treatment rates, with 1400 patients without any lithotripsy treatment being used as the comparison cohort. A Cox proportional hazards regression model was applied. Our results indicate that the risk of repeat urolithiasis treatment was 1.71-fold higher in patients that received lithotripsy when compared to patients that were not treated with lithotripsy (hazard ratio (HR) 1.71; 95% confidence interval (CI) = 1.427–2.048; p < 0.001). Furthermore, a high percentage of repeated treatment was observed in the ESWL group (HR 1.60; 95% CI = 1.292–1.978; p < 0.001). Similarly, the PCNL group was also independently associated with a high chance of repeated treatment (HR 2.32; 95% CI = 1.616–3.329; p < 0.001). Furthermore, age, season, level of care, and Charlson comorbidities index (CCI) should always be taken into consideration as effect factors that are highly correlated with repeated treatment rates. MDPI 2022-12-16 /pmc/articles/PMC9780782/ /pubmed/36556495 http://dx.doi.org/10.3390/life12122130 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chiou, Yueh-Er
Chung, Chi-Hsiang
Chien, Wu-Chien
Tsay, Pei-Kwei
Kan, Hung-Cheng
Weng, Wen-Hui
A Comparative Study of Stone Re-Treatment after Lithotripsy
title A Comparative Study of Stone Re-Treatment after Lithotripsy
title_full A Comparative Study of Stone Re-Treatment after Lithotripsy
title_fullStr A Comparative Study of Stone Re-Treatment after Lithotripsy
title_full_unstemmed A Comparative Study of Stone Re-Treatment after Lithotripsy
title_short A Comparative Study of Stone Re-Treatment after Lithotripsy
title_sort comparative study of stone re-treatment after lithotripsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780782/
https://www.ncbi.nlm.nih.gov/pubmed/36556495
http://dx.doi.org/10.3390/life12122130
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