Page 4 - CUA 2020_Endourology
P. 4
2020 CUA Abstracts
Methods: Using previously validated linked administrative databases, HRQOL score, this study indicates an association between MetS and
we performed a population-based retrospective study of all opioid-naive increased nephrolithiasis symptoms. Specific criterion of MetS (BMI >30
patients age 25 years or younger with a diagnosis of urolithiasis between and diabetes mellitus) are linked to lower HRQOL scores as well. This
July 1, 2013 and September 30, 2017 in Ontario, Canada. Our primary lends support to holistic, personalized stone patient care.
outcome was persistent opioid use defined as filling a prescription for an References
opioid between 91 and 180 days after initial urolithiasis visit. Secondary 1. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and man-
outcomes were opioid addiction and opioid overdose. agement of the metabolic syndrome: An American Heart
Results: Of the 6962 patients identified, 56% were prescribed an opi- Association/National Heart, Lung, and Blood Institute Scientific
oid at presentation and 34% of those were dispensed more than 200 Statement. Circulation 2005;112:2735-52. https://doi.org/10.1161/
oral morphine equivalents. There was persistent opioid use in 313 (8%) CIRCULATIONAHA.105.169404
patients who filled an initial opioid prescription. Those prescribed an 2. DiBianco JM, Jarrett TW, Mufarrij P. Metabolic syndrome and
opioid initially had a significantly higher risk of persistent opioid use (odds nephrolithiasis risk: Should the medical management of nephro-
ratio [OR] 1.8; 95% confidence interval [CI] 1.5–2.3), opioid addiction lithiasis include the treatment of metabolic syndrome? Rev Urol
(OR 3.6; 1.2–10.6), and opioid overdose (OR 2.8; 0.9–8.6) compared to 2015;17:117-28.
those without initial opioid exposure. In adjusted analysis, initial exposure 3. Karimi M, Brazier J. Health, health-related quality of life, and quality
of >300 oral morphine equivalents (OR 2.2; 1.5–3.3), history of mental of life: What is the difference? Pharmacoeconomics 2016;34:645-9.
illness (OR 1.3; 1.0–1.7), and need for surgery (OR 1.7; 1.2–2.3) were https://doi.org/10.1007/s40273-016-0389-9
all risk factors for persistent opioid use (Table 1). 4. Penniston KL, Antonelli J, Viprakasit D, et al. Validation and reli-
Conclusions: Among urolithiasis patients age 25 years or younger, filling ability of the Wisconsin stone quality of life questionnaire. J Urol
an opioid prescription after presentation is associated with an increased 2017;197:1280-8. https://doi.org/10.1016/j.juro.2016.11.097
risk of persistent opioid use 3–6 months later and a higher risk of serious
long-term complications, such as opioid addiction and overdose. POD-1.5
Wisconsin Quality of Life Machine Learning Algorithm for
POD-1.4 predicting the quality of life in kidney stone patients
Metabolic syndrome negatively impacts stone specific quality David-Dan Nguyen , Jack W. Luo , Jonathan R.Z Lim , Kymora Scotland ,
1
3
1,2
3
of life: Results from the North American Stone Quality of Life Seth K. Bechis , Roger L. Sur , Stephen Y. Nakada , Jody A. Antonelli ,
4
5
6
4
Consortium Necole M. Streepe , Sri Sivalingam , Davis P. Viprakasit , Timothy D.
8
7
9
Jonathan Lim , Kymora Scotland , Seth K. Bechis , Roger L. Sur , Stephen Averch , Jaime Landman , Thomas Chi , Vernon M. Pais, Jr. , Vincent
2
1
1
12
13
2
10
11
Y. Nakada , Sri Sivalingam , Timothy D. Averch , Jaime Landman , Thomas G. Bird , Sero Andonian , Noah E. Canvasser , Jonathan D. Harper ,
3
14
17
4
5
15
16
6
Chi , Sero Andonian , Naeem Bhojani , Noah E. Canvasser , Jonathan D. Ben H. Chew , Kristina L Penniston , Naeem Bhojani 18
3
9
10
7
8
5
Harper , Kristina L. Penniston , Ben H. Chew 1 1 Faculty of Medicine, McGill University, Montreal, QC, Canada; Health
3
11
2
1 Department of Urologic Sciences, University of British Columbia, Policy and Management, Harvard T.H. Chan School of Public Health,
Vancouver, BC, Canada; School of Medicine, University of San Diego, Boston, MA, United States; Urologic Sciences, University of British
3
2
San Diego, CA, United States; School of Medicine and Public Health, Columbia, Vancouver, BC, Canada; Urology, University of California
4
3
University of Wisconsin, Madison, WI, United States; Glickman San Diego School of Medicine, San Diego, CA, United States; Urology,
5
4
Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, United University of Wisconsin School of Medicine and Public Health, Madison,
States; Palmetto Health USC Medical Group, Columbia, SC, United WI, United States; Urology, University of Texas Southwestern Medical
5
6
States; School of Medicine, University of California Irvine, Orange, Center, Dallas, TX, United States; Urology, Pennsylvania State University
7
6
CA, United States; School of Medicine, University of California San College of Medicine, Hershey, PA, United States; Glickman Urological
8
7
Francisco, San Francisco, CA, United States; McGill University Health
8
Centre, Montreal, QC, Canada; Université de Montréal, Montreal, QC,
9
Canada; School of Medicine, University of California Davis, Sacramento,
10
CA, United States; University of Washington, Seattle, WA, United States
11
Introduction: Metabolic syndrome (MetS) is a collection of metabolic
comorbidities that is linked to the formation of atherosclerotic cardio-
vascular disease. Recently, MetS has been connected to an increased
1
risk of nephrolithiasis. In light of this association, this study aimed to
2
assess the hypothesis that the presence of MetS is linked to a decreased
health-related quality of life (HRQOL) in active stone-forming patients. 3
Methods: This is a multi-institutional prospective study by the North
American Stone Quality of Life Consortium. All sites used the Wisconsin
stone quality of life questionnaire (WISQOL) — a validated survey — to
evaluate patient stone specific HRQOL. In addition to WISQOL, sites also
4
collected medical history. This was used to distinguish MetS patients from
non-MetS patients. Patients who were active stone-formers were identi-
fied. Among these active stone-formers, MetS patients were compared to
non-MetS patients using a Wilcoxon rank sum test.
Results: In active stone-formers, there was a significant difference in stone
specific HRQOL between MetS (median 102/140) and non-MetS patients
(median 106/140; p<0.05). Patients with body mass index (BMI) >30 or
diabetes mellitus (part of criteria for MetS) also had a significantly lower
HRQOL compared to non-BMI >30 and non-diabetes mellitus patients,
respectively. In this study, all patients had stones, but those with MetS or
associated criterion had lower HRQOL.
Conclusions: In the management of stones, asymptomatic or tolerably
symptomatic stones may not require surgical treatment. Thus, factors that
are associated with symptoms need to be identified. These factors can
then be treated to decrease symptomaticity. Observed through a lower POD-1.5. Fig. 1. Out-of-sample correlation between quality of life estimates
and WISQOL total score (r=0.622).
S26 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)