title: Patient and stone characteristics associated with surgical intervention in pediatrics.
abstract: BACKGROUND
  The incidence of kidney stones in children is increasing. While guidelines exist for acute surgical intervention, there is limited data to inform the decision as to when to intervene non-urgently.
  
  
  OBJECTIVE
  To identify patient and stone characteristics predicting stone surgery in children.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Stollery Children's Hospital, Edmonton, Alberta, Canada from 1990 to 2013.
  
  
  METHODS
  Sixty-three children aged 0-18 years old who presented with a total of 142 stones.
  
  
  METHODS
  Patient's surgical history, demographics, metabolic measures, and stone number, type, and location.
  
  
  METHODS
  Univariate and multivariate analysis, controlling for presentation number and individual-level variation by repeated measures analysis were conducted to assess for patient and stone characteristics associated with surgical intervention.
  
  
  RESULTS
  Sixty-five percent (41/63) required surgery during a mean follow-up of 19 months. Stone characteristics associated with surgical intervention by multivariate analysis included larger stone size (>6 mm), and stone composition of calcium oxalate.
  
  
  CONCLUSIONS
  Single center study with a limited sample size and duration of follow up, thereby limiting predictive power. There were some missing data (i,e. stone type was not always available). Despite this, stone type remained significant in multivariate modeling.
  
  
  CONCLUSIONS
  Stone size > 6mm and composition with calcium oxalate but not patient age or symptoms associated with presentation predicted surgical intervention. These observations can be used to inform decisions as to whether urolithiasis should be surgically managed electively or observed.
authors.affiliation: Department of Surgery, The University of Alberta, Edmonton, AB T6G 1C9 Canada.
authors.forename: Esther
authors.initials: E
authors.lastname: Jun
authors.affiliation: Department of Surgery, The University of Alberta, Edmonton, AB T6G 1C9 Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Metcalfe
authors.affiliation: Department of Pediatrics, The University of Alberta, Edmonton, AB T6G 1C9 Canada.
authors.forename: Piush J
authors.initials: PJ
authors.lastname: Mandhane
authors.affiliation: Department of Pediatrics, The University of Alberta, Edmonton, AB T6G 1C9 Canada.
authors.forename: R Todd
authors.initials: RT
authors.lastname: Alexander
keywords: Kidney stone surgery; Pediatrics; Urolithiasis