尿路結石之季節變異性
丁偉峰 王敘涵* 朱聖賢 陳孝文 王大民 江仰仁 劉冠麟 林國仁
林口長庚紀念醫院 外科部 泌尿外科
The seasonal meteorological variation on urolithiasis
Wei-Feng Ding, Hsu-Han Wang*, Sheng-Hsien Chu, Hsiao-Wen Chen, Ta-Min Wang, Yang-Jen Chiang, Kuan-Lin Liu, Kuo-Jen Lin
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou
Purpose:
The incidence of urolithiasis increases in warm climate region as well as during summer months. The purpose of this study is to analysis the impact of climate factors on the prevalence of urolithiasis in our hospital.
Material and Method:
We retrospectively reviewed the records of extracorporeal shockwave lithotripsy (ESWL) performed in our hospital from January 2007 to December 2014. Total number of ESWL procedures was recorded monthly during this 8-year period. Repeated ESWL of same patient within one month was excluded and we only count as one ESWL in our study. Total out-patient numbers at our hospital were used as an estimation of population. Climate data of the corresponding months were collected from Central Weather Bureau. Available monthly meteorological data include highest, lowest and average temperature, average humidity, total rainfall, total rain days, total sun-shine hours, average atmospheric pressure and maximum 10-min wind speed.
Results:
Monthly ESWL rate is positively associated with average temperature (B=0.661, p < 0.001), rainfall (B=0.294, p=0.023), sun-shine hours (B=0.471, p<0.001) and wind-speed (B=0.310, p=0.016); while it is negatively related with humidity (B=-0.378, p=0.003) and atmospheric pressure (B=-0.531, p< 0.001) in univariate linear regressions. When we examine these factors together in multivariate linear regression, only monthly average temperature and atmospheric pressure remain significant association to ESWL rate. Using Poisson regression model, we further validated that temperature (B=0.051, 95%CI: 0.034-0.068, p<0.001) and atmospheric pressure (B=0.029, 95%CI: 0.015-0.044, p<0.001) have independent influence on monthly ESWL number, while the rest climate factors are insignificant.
Conclusion:
Temperature and atmospheric pressure are associated with monthly ESWL rate. Ambient temperature is the most important climate factor affecting urolithiasis prevalence in northern Taiwan.