Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life.

IF 1.8 Q3 UROLOGY & NEPHROLOGY

Advances in Urology Pub Date : 2020-07-30 eCollection Date: 2020-01-01 DOI:10.1155/2020/2108362

Anthony J Schaeffer, Patrick C Cartwright, Glen A Lau, Mark D Ebert, Nora F Fino, Flory L Nkoy, Rachel Hess

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引用次数: 1

Abstract

Purpose: The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. Study Design and Data Source. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. Data Collection. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. Primary Outcome. Sum of radiologic studies within the first year of life or prior to pyeloplasty. Statistical Analysis. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade.

Results: Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42-1.73) and severe (RR: 2.09; 95% CI: 1.88-2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders.

Conclusions: In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.

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在出生后12个月的婴儿肾积水的影像学应用。

目的:婴儿肾积水(HN)的检查和监测策略各不相同，尽管这可能是由于成像强度的分级依赖差异。我们的目的是描述在一个大型区域医疗保健系统中，HN在出生后第一年的影像学检查频率，按HN的初始级别分层。研究设计和数据来源。使用Intermountain医疗数据仓库的回顾性队列研究。纳入标准:(1)2005年1月1日至2013年12月31日出生，(2)CPT编码为HN，(3)出生4个月内超声(U/S)证实HN。数据收集。产后初始U/S的HN分级;hn相关放射学研究的数量(肾脏U/Ss、排尿膀胱输尿管图(VCUGs)和利尿肾扫描);人口统计和医学变量。主要的结果。生命第一年或肾盂成形术前的放射学研究的总和。统计分析。多变量泊松回归分析主要结局与初始HN分级之间的关系。结果:1380例(男性993例，女性387例)中，轻度、中度、重度HN患者分别为990例(72%)、230例(17%)、160例(12%)。与轻度HN患者相比，中度HN患者(RR: 1.57;95% CI: 1.42-1.73)和严重(RR: 2.09;95% CI: 1.88-2.32)在控制了潜在的混杂因素后，HN在12个月内(或手术前)的影像学使用率明显更高。结论:在大型区域医疗保健系统中，HN的影像学使用与其初始分级成正比。这表明，在我们的系统内，临床医生治疗这种情况正在使用风险分层的方法来成像。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Urology UROLOGY & NEPHROLOGY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.