1838 INCIDENCE OF RENAL HEMORRHAGE AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IN COMPARISON WITH THREE SHOCK WAVE GENERATORS IN 482 HOSPITALS; JAPANESE DIAGNOSIS PROCEDURE COMBINATION DATABASE (2011)

You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111838 INCIDENCE OF RENAL HEMORRHAGE AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IN COMPARISON WITH THREE SHOCK WAVE GENERATORS IN 482 HOSPITALS; JAPANESE DIAGNOSIS PROCEDURE COMBINATION DATABASE Toru Sugihara, Hideo Yasunaga, Hiromasa Horiguchi, Hiroaki Nishimatsu, Haruki Kume, Yoshikazu Hirano, Takeshi Kawamura, Shinya Matsuda, and Yukio Homma Toru SugiharaToru Sugihara Tokyo, Japan , Hideo YasunagaHideo Yasunaga Tokyo, Japan , Hiromasa HoriguchiHiromasa Horiguchi Tokyo, Japan , Hiroaki NishimatsuHiroaki Nishimatsu Tokyo, Japan , Haruki KumeHaruki Kume Tokyo, Japan , Yoshikazu HiranoYoshikazu Hirano Tokyo, Japan , Takeshi KawamuraTakeshi Kawamura Tokyo, Japan , Shinya MatsudaShinya Matsuda Fukuoka, Japan , and Yukio HommaYukio Homma Tokyo, Japan View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1857AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal hemorrhage is not common but a severe adverse event after extracorporeal shock wave lithotripsy (ESWL). We compared three types of shock wave generators in regard to the incidence rate of renal hemorrhage, using Japanese administrative claim database. METHODS The Diagnosis Procedure Combination database is an inpatient care database in Japan that includes administrative claim data and discharge data. The database contains information on diagnoses, comorbidities and complications coded according to International Classification of Diseases and Related Health Problems, Tenth Revision; surgical procedures; duration of anesthesia; volume of blood transfusion; and discharge status. It covered about 40% (2.86 million in 855 hospitals) of all acute care inpatient hospitalizations in 2008. As study samples, patients who underwent ESWL for urolithiasis were collected from July 1 to December 31, 2006–2008. The lithotripters set in each hospital were identified by searching published articles and visiting hospital websites. Shock wave generators were classified into three types; eletrohydraulic, electromagnetic and piezoelectric types. Renal hemorrhages were identified by Japanese disease name and those incidences were followed 30 days after ESWL including re-admissions. The multivariate logistic regression analysis was conducted to model the concurrent effects of generator types, age, sex, annual hospital ESWL session volume (1–70, 71–139, 140+), individual treatment times (1, 2+), anesthesia use, stone location and laterality. RESULTS We surveyed 26,969 patients (32,476 sessions) at 482 hopitals; sixteen electrohydraulic generator devices (126 hospitals, 6,705 patients), nineteen electromagnetic generator devices (318 hospitals, 17,931 patients) and five piezoelectric generator devices (38 hospitals, 1,832 patients). Eighty-one renal hemorrhages were identified and overall incidence rates were 0.50% in kidney stones and 0.14% in ureteral stones (p < 0.01). A high ESWL session volume (vs. low-) and a piezoelectric type (vs. electromagnetic) were significant factors (adjusted odds ratio [OR], 0.48, p = 0.01; OR, 0.13, p = 0.04). Multiple ESWL sessions (vs. single) didn't reach a significant level (OR, 1.72, p = 0.054). CONCLUSIONS Renal hemorrhage events are not very rare. We found piezoelectric generators and volume-outcome effect affects those events. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e737 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toru Sugihara Tokyo, Japan More articles by this author Hideo Yasunaga Tokyo, Japan More articles by this author Hiromasa Horiguchi Tokyo, Japan More articles by this author Hiroaki Nishimatsu Tokyo, Japan More articles by this author Haruki Kume Tokyo, Japan More articles by this author Yoshikazu Hirano Tokyo, Japan More articles by this author Takeshi Kawamura Tokyo, Japan More articles by this author Shinya Matsuda Fukuoka, Japan More articles by this author Yukio Homma Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...