支架或治疗:预测最终的石头管理的患者出现在急诊室的尿病
Victoria S Edmonds1, Viengneesee Thao2, James P Moriarty2
1Department of Urology, Mayo Clinic Arizona, Phoenix, AZ.
Urology
|August 23, 2025
概括
患者和医院因素影响尿道结石的最终治疗. 年龄较大,并发病率较高,周末住院和美国东北部医院减少石头治疗的可能性,而收入较高则增加了这种可能性.
科学领域:
- 泌尿外科
- 医疗服务研究
- 紧急医疗
背景情况:
- 尿道结石是一种常见的急诊部 (ED) 呈现.
- 治疗策略有所不同,包括最终管理 (例如,尿管透视) 和减压 (支架/管切除).
- 影响治疗选择的因素尚未完全理解.
研究的目的:
- 确定与ED相关的患者和设施特征与非复杂的尿道结石的初级终极治疗相比.
主要方法:
- 全国紧急部门样本 (2016-2019) 医疗保健成本和利用项目的分析.
- 包括成人ED遇到尿路结石的初步诊断,不包括感染或急性功能衰竭.
- 权重多层物流回归建模以考虑个人和医院的权重和集群.
主要成果:
- 在1,253,000例ED患者中,有86%没有进行手术.
- 在接受治疗的患者中,43%仅接受了减压,57%接受了终极治疗.
- 年龄较大,并发病率较高,周末呈现,较早访问年份,以及美国东北部的医院位置与较低的最终治疗率有关. 较高的收入四分位数与更高的终极治疗率有关.
结论:
- 患者和机构的特征显著预测了接受无并发性尿道结石的初级最终治疗的可能性.
- 在治疗中存在差异,可能导致患者和系统负担增加.
- 需要进一步的研究以确保对尿道结石进行公平有效的资源分配.
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