A large 15 - year database analysis on the influence of age, gender, race, obesity and income on hospitalization rates due to stone disease.
OBJECTIVE
To assess the public hospitalization rate due to stone disease in a large developing nation for a 15-year period and its association with socio-demographic data.


METHODS
A retrospective database analysis of hospitalization rates in the Brazilian public health system was performed, searching for records with a diagnosis code of renal/ureteral calculi at admission between 1998-2012. Patients managed in an outpatient basis or private care were excluded. Socio-demographic data was attained and a temporal trend analysis was performed.


RESULTS
The number of stone-related hospitalizations increased from 15.7%, although the population-adjusted hospitalization rate remained constant in 0.04%. Male:female proportion among hospitalized patients was stable (49.3%:50.7% in 1998; 49.2%:50.8% in 2012), though there was a significant reduction in the prevalence of male hospitalizations (-3.8%;p=0.041). In 2012, 38% of hospitalized patients due to stone disease had 40-59 years-old. The ≥80 years-old strata showed the most significant decrease (-43.44%;p=0.022), followed by the 20-39 (-23.17%;p < 0.001) and 0-19 years-old cohorts (-16.73%;p=0.012). Overall, the lowest relative hospitalization rates were found for yellow and indigenous individuals. The number of overweight/obese individuals increased significantly (+20.6%), accompanied by a +43.6% augment in the per capita income. A significant correlation was found only between income and obesity (R=0.64;p=0.017).


CONCLUSIONS
The prevalence of stone disease requiring hospitalization in Brazil remains stable, with a balanced proportion between males and females. There is trend for decreased hospitalization rates of male, < 40 and ≥80 years-old individuals. Obesity and income have a more pronounced correlation with each other than with stone disease.
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Marcos F
MF
Mello
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Giovanni Scala
GS
Marchini
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Cesar
C
Câmara
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Alexandre
A
Danilovic
Departamento de Medicina Preventiva da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Renata
R
Levy
Departamento de Medicina Preventiva da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
José
J
Eluf-Neto
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Miguel
M
Srougi
Seção de Endourologia, Divisão de Urologia do Hospital das Clínicas da Universidade de São Paulo, Faculdade de Medicina de São Paulo, Brasil.
Eduardo
E
Mazzucchi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D005843:Geography; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007223:Infant; D007669:Kidney Calculi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014514:Ureteral Calculi / Q000453:epidemiology; D052878:Urolithiasis / Q000453:epidemiology*; D055815:Young Adult
Disease; Kidney Calculi; Urolithiasis