Category: Epidemiology, Health Policy, Socioeconomics & Outcomes

MP33-1 - Lessons on mortality from conservatively managed kidney stone disease in the last two decades

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Kidney stone disease (KSD) incidence is increasing globally, however, it is not perceived as a life-threatening condition and there are no publications examining its mortality rate. Our aim was to ascertain the number of KSD mortalities related to conservative management reported over the past two decades, identify risk factors, and to summarise their key learning points.


Methods :

A search was conducted for full-text English language articles that reported on KSD associated mortality published between 1999 to 2017. We included articles that reported on conservative management alone. Risk of bias assessment was undertaken using the Joanna Briggs critical appraisal tool.


Results :

We identified 2786 articles from our search, with the majority reporting on intervention related KSD mortality. Table 1 displays 30 reported mortalities that were related to conservative management. The main risk factor for mortality was patients with multiple co-morbidities, though the cause of death was not specified. The main recommendations were the aggressive treatment of pre-operative UTI or the use of prophylactic antibiotics, and early decompression of the renal systems been proven to improve outcomes. The quality of included articles was moderate to good.


Conclusions :

Pre-procedural optimisation of patients, and aggressive treatment of pre-operative UTI is key to preventing KSD mortality, especially in patients with multiple co-morbidities. Surgeons should aim for timely decompression of patients presenting with sepsis, as early intervention improves outcomes.

Lily Whitehurst

UROLOGY REGISTRAR
UHS
Southampton, England, United Kingdom

Bhaskar K. Somani

Consultant Urologist, Associate Professor
University Hospital Southampton , U.K
Southampton, England, United Kingdom

Bhaskar is an Endourologist and Associate Professor in Southampton, and is an active member of European School of Urology 'Training and Research group' and ESUT Endourology group. He has been teaching on EUREP hands-on-training for the last 5 years and is the senior author in the new ‘Endoscopic stone treatment (EST)’ curriculum established for training and examinations. He has performed live surgery in EAU with presentations and moderations in EULIS, WCE and SIU. He is also a member of EAU ‘Train the Trainer’ committee.

He is research active and has published more than 200 papers with over 300 published abstracts/presentations. He is on the editorial board of 3 journals, a reviewer for 14 journals and Investigator for 5 trials. He sits on the MCQ panel for FRCS examinations and is a ‘Specialist advisor’ to National Institute of Clinical Excellence (NICE) Interventional procedures and ‘Invited expert’ to NICE urological infections. He is an elected member of BAUS Academic section and was recently selected as a Fellow of Faculty of Surgical Trainers.

Patrick Jones

Resident
University Hospital Southampton
Southampton, England, United Kingdom

Sadaf Karim Sulaiman

Core Surgical Trainee
University Hospital Southampton NHS Trust
London, England, United Kingdom

Dr. Sadaf Karim Sulaiman, MBBS
I am currently a core surgical trainee at University Hospital Southampton, United Kingdom. `