National Practice Pattern and Time Trends in Treatment of Upper Urinary Tract Calculi in Korea: a Nationwide Population-Based Study.
Despite high prevalence of upper urinary tract calculi (UUTC), there are few studies regarding patterns of care in Asian populations. We investigated treatment patterns and time trends in patients with newly diagnosed UUTC in Korea using the National Health Insurance database that includes de-identified claims from a random 2% sample of the entire population (> 1 million people). A total of 14,282 patients who received active treatments, including shock wave lithotripsy (SWL), ureteroscopic surgery (URS), percutaneous nephrolithotomy (PNL), and uretero/pyelolithotomy (UPL), for newly diagnosed UUTC between 2003 and 2013 were included. The number of primary and all treated cases of UUTC significantly (43% and 103.3%, respectively) increased over the 10-year period. While patients undergoing SWL, URS, PNL, and UPL as primary treatment increased by 43.7%, 31.9%, 87.5%, and 0%, respectively, the relative proportion undergoing each treatment remained constant over the 10 years (SWL > 90%, URS 4.5% to 7.8%, PNL 0.4% to 1.0%, and UPL < 0.4%, respectively). Multinomial logistic regression analysis showed that age > 40 years (compared to age < 30 years) was significantly associated with URS, PNL, and UPL, rather than SWL, while patients living in urban or suburban/rural areas (compared to metropolitan) were significantly less likely to undergo URS and PNL. In summary, the majority of Korean patients underwent SWL as primary treatment for UUTC, and the predominant use of SWL remained steady over a 10-year period in Korea. Our results will be valuable in examining treatment patterns and time trends in Korean UUTC patients.
Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea. jspark.uro@gmail.com.
Jinsung
http://orcid.org/0000-0001-6158-3359
J
Park
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Beomseok
http://orcid.org/0000-0003-0644-5855
B
Suh
Department of Microbiology and Immunology, Eulji University School of Medicine, Daejeon, Korea.
Myung Shin
http://orcid.org/0000-0001-9145-6190
MS
Lee
Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
Seung Hyo
http://orcid.org/0000-0002-7636-2679
SH
Woo
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Dong Wook
http://orcid.org/0000-0001-8128-8920
DW
Shin
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000639:trends; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000639:trends; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*
Clinical Practice Pattern; Lithotripsy; Ureteroscopic Surgery; Urinary Calculi