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The Epidemiology of Urolithiasis and Study on Influential Factors Related to Extracorporeal Shock Wave Lithotripsy

Author: LuYanHua
Tutor: LuYunXia；ZhangDongFang
School: Huazhong University of Science and Technology
Course: Epidemiology and Biostatistics,
Keywords: Urolithiasis Temporal characteristics Extracorporeal shock wave lithotripsy Influencing factors Logistic regression
CLC: R699
Type: Master's thesis
Year: 2011
Downloads: 18
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Abstract


Objective To analyze the temporal distribution of urolithiasis occur, provide the basic information for the prevention and treatment of urolithiasis. On this basis, the collection of basic characteristics and treatment of patients with ureteral stones using a multiple regression model to explore the factors that affect the efficacy of extracorporeal shock wave lithotripsy, and to provide a scientific basis for the treatment of ureteral stones. Methods Fourth People's Hospital in Shenzhen gravel Branch on January 1, 2003 to 2009, the basic characteristics and treatment of patients with stones of extracorporeal shock wave lithotripsy. The concentration ratio and the circular distribution law of the time of onset of urolithiasis in 2007 to 2009, 2151 patients for statistical analysis. On this basis, the retrospective extracorporeal shock wave lithotripsy influencing factors of 1203 patients with ureteral stones. Each patient from the start of treatment and follow-up three months after the assessment of its therapeutic effect. The calculus completely ruled out as a successful treatment, the stones are not crushed or residual stones treatment failure. Successful group of successful treatment group can also be further divided into a row of stone success group and two or more rows of stone. Using the chi-square test, t-test and analysis of variance for univariate analysis. Consider single-factor analysis of significant variables based on previous research experience, choose the variable fitting multivariate logistic regression analysis model, and create a regression model to predict stones completely discharged probability. The statistical significance level was set at 0.05, two-sided test, using SAS 9.13 for statistical analysis. Results of the concentration and the circular distribution of the results of the two methods show that the the urolithiasis incidence has certain time aggregation. Among them, the high incidence of urolithiasis occur in summer in August, ureteral stones and kidney stones, high incidence in August and July. In the treatment influencing factors, the stones completely discharged 1,076 cases, with a total stone-free rate of 89.44%, one of gravel success of the 955 cases, accounting for 88.75% of the rubble of success; 2 gravel and the success of the 121 cases, accounting for gravel 11.25%; stones is not fully discharged 127 cases, the failure rate of 10.56%. 118 patients (9.81%) after treatment complications. The expansion efficiency quotient is calculated according to the formula of efficiency of 0.80. Univariate analysis, gender, duration of symptoms, water level, stone location, stone long diameter stones transverse diameter and stone burden of these nine factors affect the stone-free rate. Multivariate analysis revealed that sex, stone location, water level, and stone burden of these four factors affect the statistical significance of the row of stone success, and build predictive models of these four factors, with a sensitivity of 84.2%, specificity was 40.9%, and accuracy of 79.6%, the false-positive rate of 7.6%, the false-negative rate of 76.6%. The area under the ROC curve of the predictive value of the row of stone effect 0.715. Conclusion of urolithiasis time characteristics analysis suggests the high incidence of the disease during the health education and prevention interventions should be further strengthened. The main effects of extracorporeal shock wave lithotripsy factors including gender, symptoms, water and stone burden. According to these important factors to establish the probability of regression analysis model to predict patients with ureteral stones after lithotripsy success row of stone, with a reference value for the patient's preoperative screening and help to further improve the therapeutic effect of extracorporeal shock wave lithotripsy.

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