Trends in Upper Tract Stone Disease in England: Evidence from the Hospital Episodes Statistics Database

Abstract

Aims: The study aimed to determine the current trends in urolithiasis-related admissions and associated interventions in England between 2006/2007 and 2013/2014 utilizing Hospital Episode Statistics (HES) online data. Material and Methods: Data was extracted from the online HES data set for each year from 2006/2007 to 2013/2014 inclusive. Admissions and procedural interventions were identified from their corresponding OPCS-4 and ICD-10 codes. Results: Finished consultant episodes (FCEs) for urolithiasis have increased by 20% over the last 7 years, with 93,039 FCEs in the year 2013/2014. Based on English population statistics, the lifetime prevalence of urolithiasis based on hospital-related admission/intervention data for 2013/2014 is 14%. The biggest increases were seen in those aged ≥75 years (up by 51%, n = 2,853). Total interventions have increased from 28,624 to 42,068, with increased rates of shock wave lithotripsy (26%), ureteroscopy (URS; 86%) and percutaneous nephrolithotomy (149%). Emergency URS procedures have increased by 38%. Day-case rates for ureteric and renal URS, in 2013/2014, were 22 and 21%, respectively. Conclusions: Over the last 7 years, there is a rising prevalence of kidney stone disease with associated increase in the number of interventions related to it. Both elective and emergency URS procedures are increasing, with a rising trend for day-case URS. Similar trends are seen worldwide and future resource planning for urolithiasis is needed to match the increase in demand.

Safety and Efficacy of Flexible Ureteroscopy in Combination with Holmium Laser Lithotripsy for the Treatment of Bilateral Upper Urinary Tract Calculi

“…Urinary stones are typically classified by their locations or chemical compositions such as calcium, struvite, and uric acid. According to English population statistics, the lifetime prevalence of urolithiasis on the basis of hospitalassociated admission/intervention information for 2013/2014 is 14%, and the greatest increases are seen in those aged ≥ 75 years [1] . Currently, external shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) are used as first-line therapies for the management of renal stones [2,3] .…”

Ureteroscopy for stone disease: expanding roles in the modern era

“…The incidence of urolithiasis is increasing with an incidence of 9–14%, becoming a major burden on healthcare systems and an adverse impact on patient’s lives [1, 2, 3]. In England, the incidence is closer to 14% and the number of admissions for stone disease has risen by 20% over 7 years from 2006/07 to 2013/14 [1].…”

“…In England, the incidence is closer to 14% and the number of admissions for stone disease has risen by 20% over 7 years from 2006/07 to 2013/14 [1]. This is being attributed to a number of factors including increasing rates of obesity, diabetes, dehydration and an aging population [1, 2]. Indeed, recent data from England demonstrated an increased incidence in patients over the age of 75.…”

“…Indeed, recent data from England demonstrated an increased incidence in patients over the age of 75. In this cohort of patients, there was a 51% rise in the incidence of urolithiasis from 2006/07 to 2013/14 [1]. There is also a strong association of metabolic syndrome with kidney stone disease [2, 4].…”

“…There is also a strong association of metabolic syndrome with kidney stone disease [2, 4]. Treatments of urolithiasis have risen over the same time with 47% more procedures performed over the last decade; mainly URS, but shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) have also shown an overall increase [1]. The trend appears to be moving towards day case URS, with England seeing a three-fold increase in the number of treatments from 2006/07 to 2013/14 [1].…”