Seasonal Variation in the Frequency of Presentation with Acute Ureteral Colic and Its Association with Meteorologic Factors

Abstract

Introduction: A seasonal variation in the frequency of acute stone presentations has been observed in studies from the United States, Africa, and Asia. The increased incidence of acute stone presentations during periods of warm weather has been attributed to both the dehydrating effect of elevated temperatures and the vitamin D related increase in calciuria during periods of increased sunshine. The aim of this study is to establish whether the association between various meteorologic parameters and the frequency of acute stone presentations also exists in a European climate. Methods: All computed tomography kidneys, ureters and bladder scans performed by Emergency Departments within the Dublin Midland Hospital Group between June 2017 and September 2018 were identified from the national radiologic database. The date of scan in addition to stone parameters (site, size, and side) was recorded. These data were then correlated with weather recordings obtained from the Irish meteorologic office. Results: A total of 2441 patients were investigated for suspected renal colic during the study period of which 781 were confirmed to have ureteral stones. An increased frequency of acute stone presentations was observed during the summer months of both years (June, July, and August). Unexpectedly, the heat wave of summer 2018 was not associated with an increased frequency of nephrolithiasis compared with summer 2017. Conclusion: There is an increased frequency of acute nephrolithiasis during the summer months in Ireland. Health care services should be tailored to expect an increase in service needs during these periods of increased activity.

Heat-health vulnerability in temperate climates: lessons and response options from Ireland

“…Regarding other NCDs, in our Irish search of the literature, Roche et al [44] found an association during the summer months in Ireland (Dublin), for an increased frequency of presentations to Emergency Departments for acute renal stones. Furthermore, a study conducted by Flaherty et al [55] suggested that specific travel advice should be provided to obese people that may exhibit poor heat tolerance travelling to warm climates.…”

“…In the global meta-analysis conducted by Bouchama et al [42] [43]. Roche et al [44] in their analysis of computer tomography kidney, ureters and bladder scans in an Irish hospital group, did find that older adults (> 65 years) were more susceptible to ureteral colic during warm weather compared to those below 65 years old, potentially due to an increased susceptibility to dehydration. Older adults (> 75 years) were identified as a particularly vulnerable group in Pascal et al's [26] study of heatwaves and mortality in Ireland.…”

“…Although gender and heat-vulnerability has not been well characterised in the literature, it may be that occupational status may be a relevant factor in many studies suggesting a heat and gender-vulnerability association, usually placing males at greater risk [8]. Indeed, in a study of acute nephrolithiasis during summer in Ireland, men were found to be at greater risk of developing stones in warm weather compared to women [44]. However, in a global study focused on women firefighters, there is evidence to suggest that they suffer from heat-related illness at work with the call for further specific heat-related support for this heat-vulnerable population [81].…”