title: Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study.
abstract: OBJECTIVE
  This study examined the prevalence of risk factors for urological stone surgery and their possible influence on outcome and complications following ureteroscopy (URS).
  
  
  METHODS
  The Clinical Research Office of the Endourological Society Ureteroscopy Global Study collected prospective data on consecutive patients with urinary stones treated with URS at centers around the world for 1 year. The prevalence of common comorbidities and anticoagulation therapy and their relationship with complications and age were examined.
  
  
  RESULTS
  Of 11,719 patients, 2,989 patients (25.8%) had cardiovascular disease, including 22.6% with hypertension, and 1,266 patients (10.9%) had diabetes mellitus. Approximately six percent of patients were receiving oral anticoagulation therapy, including aspirin (3.7%) and clopidogrel (0.8%). The prevalence of hypertension and diabetes mellitus and the proportion of patients receiving anticoagulant medication and/or antidiabetes treatment increased with age. Elderly were more likely to develop a postoperative complication when they had diabetes, a cardiovascular disease or received anticoagulation therapy. Post-operative bleeding was higher in patients receiving anticoagulants than those not receiving them (1.1 vs. 0.4%; p < 0.01). Patients with risk factors for stone formation had more complications than those without (4.9 vs. 3.0%, p < 0.001).
  
  
  CONCLUSIONS
  This is the first study confirming in a global population that URS can effectively and safely be performed in a population with high comorbidity. The risk of a complication was highest among elderly patients presenting with comorbidities.
authors.affiliation: Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: F Pedro J
authors.initials: FP
authors.lastname: Daels
authors.forename: Andrius
authors.initials: A
authors.lastname: Gaizauskas
authors.forename: Jorge
authors.initials: J
authors.lastname: Rioja
authors.forename: Anil K
authors.initials: AK
authors.lastname: Varshney
authors.forename: Erkan
authors.initials: E
authors.lastname: Erkan
authors.forename: Yasar
authors.initials: Y
authors.lastname: Ozgok
authors.forename: Michael
authors.initials: M
authors.lastname: Melekos
authors.forename: Jean J M C H
authors.initials: JJ
authors.lastname: de la Rosette
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D000077144:Clopidogrel; D015331:Cohort Studies; D015897:Comorbidity; D003374:Coumarins / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007669:Kidney Calculi / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000453:epidemiology* / Q000601:surgery; D018666:Ureteroscopy; D052878:Urolithiasis / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D003374:Coumarins; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin