南臺灣結石病例數與氣候因子之相關性分析及尿路結石治療方式趨勢之分析

林崇裕、李香瑩

高雄醫學大學附設醫院 泌尿部

The Impact of Climate Factors on the Prevalence of Urolithiasis and the Trend of the Urinary Stone Disease Management in Southern Taiwan

Chung-Yu Lin, Hsiang-Ying Lee

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Purpose: The study is aiming to analyze the effects of climate parameters on the numbers of urolithiasis undergoing treatments in our hospital, and to understand the effects of these parameters on the prevalence of urolithiasis in southern Taiwan. We also look trends associated with urolithiasis and treatments

Materials and Methods: We retrospectively reviewed the records of extracorporeal shockwave lithotripsy (ESWL) ureteroscopy (URS), retrograde intrarenal surgery (RIRS), also known as flexible ureterorenoscopy (fURS), and percutaneous nephrolithotripsy (PCNL) performed in our hospital from January 2012 to December 2018. Climate data of the corresponding months were collected from Central Weather Bureau. The available monthly meteorological data included average temperatures, humidity, rainfall, sunshine hours, average atmospheric pressure, and wind speed.

Results: Monthly numbers of patients diagnosed with urolithiasis and undergoing stone management was positively correlated to average temperature (r = 0.657), relative humidity (r = 0.234), monthly rainfall (r = 0.261) and monthly sunshine hours (r = 0.348), while it was negatively correlated to atmospheric pressure (r = -0.522). Monthly ten‑minute wind speed was not significantly correlated to numbers of patients undergoing stone treatment. The multivariate linear regression model presented temperature (ß = 1.22, 95% CI: 6.178-14.646, p < 0.001) and relative humidity (ß = -3.224, 95% CI: -5.233- -1.216, p = 0.002) to be independently related to numbers of patients undergoing stone treatment. The data also revealed a rising prevalence of urolithiasis with associated increase in the number of interventions related to it. Both URS procedures (20.7% to 40.1%) and PCNL (5.4% to 10.2%) are increasing, with a decreased rates of ESWL(74.0% to 49.4%).

Conclusion: Temperature and relative humidity are associated with monthly numbers of patients undergoing stone treatment. Ambient temperature is the most important climate factor affecting the prevalence of urolithiasis in southern Taiwan, and stone removal surgical intervention will continue to play an important role and a steep rise of URS and minimally invasive PCNL techniques was revealed over this period in Taiwan