MP73-13 CLINICAL PRESENTATION OF UPPER URINARY TRACT STONE DIFFERS BY PATIENT AGE: A NATION-WIDE POPULATION-BASED STUDY

Abstract

INTRODUCTION AND OBJECTIVES: The aim of this study is to investigate whether clinical presentation of upper urinary tract stone differs by patient age. METHODS: We used data sourced from the National Health Insurance Research Database of Taiwan. Health Insurance System of Taiwan covers approximately 23 million people (98% of population). From 2006 to 2010, in subjects who visited emergency room (ER), we identified 121685 subjects with symptomatic upper urinary tract stone. The diagnosis of upper urinary tract stone was confirmed by the diagnosis of ICD 592.x or 274.11 for at least three times or by the procedure codes of management of upper urinary tract stone within 90 days after the ER visit. The frequencies of coding for pain, hematuria, urinary tract infection (UTI), fever, lower urinary tract symptoms (LUTS), nausea and vomiting, and dizziness were compared between age groups. RESULTS: The frequencies of coding for pain (p < 0.0001) and hematuria (p < 0.0001) decreased gradually when patient age was older. The older patients were less likely to present with pain or hematuria than younger patients. The frequencies of coding for UTI (p < 0.0001), fever (p < 0.0001), LUTS (p < 0.0001), nausea and vomiting (p < 0.0001), and dizziness (p < 0.0001) increased gradually when patient age was older. The older patients were more likely to present with UTI, fever, LUTS, nausea and vomiting, or dizziness than younger patients. Then we divided all subjects into two groups by gender. The older female patients were less likely to present with pain (p < 0.0001) or hematuria (p 1⁄4 0.0358) but more likely to present with UTI (p < 0.0001), fever (p < 0.0001), LUTS (p < 0.0001), or dizziness (p < 0.0001) than younger female patients. The older male patients were less likely to present with pain (p < 0.0001) but more likely to present with UTI (p < 0.0001), fever (p < 0.0001), LUTS (p < 0.0001), or dizziness (p < 0.0001) than younger male patients. CONCLUSIONS: Clinical presentation of upper urinary tract stone differs by patient age. The older patients were more likely to present with urinary tract infection, fever, lower urinary tract symptoms, nausea and vomiting, or dizziness and less likely to present pain or hematuria than younger patients.