Surgery and imaging rates for children's kidney stones are stable, but vary greatly from hospital to hospital

Research Activities, May 2011, No. 369

About 22 percent of 7,921 children with kidney stones underwent surgery and 80 percent underwent stone-related diagnostic imagery between 1999 and 2008—rates that remained stable throughout the period. However, computerized tomography (CT) use increased 26 percent to 45 percent and plain x-ray of kidneys, ureters, and bladders plus excretory urogram use decreased 59 percent to 38 percent during the same period, according to a study of trends in imaging and surgical management for this condition by Boston-based researchers.

Greater CT use was associated with older patient age, public insurance status, white race, and treating hospital. However, the treating hospital was the most important factor affecting CT use. The probability of CT use at the hospitals included in the study for a 16-year-old female varied from 47 percent to 84 percent.

Surgical procedure use was associated with older patient age, female gender, white race, and private insurance status. As with CT use, the treating hospital was the most important factor. The probability of a surgical procedure at each of the 40 pediatric hospitals included in the study for a 16-year-old female varied from 24 percent to 95 percent. This study was supported by the Agency for Healthcare Research and Quality (T32 HS00063).

See "Trends in imaging and surgical management of pediatric urolithiasis at American pediatric hospitals," by Jonathan C. Routh, M.D., Dionne A. Graham, Ph.D., and Caleb P. Nelson, M.D., M.P.H., in the October 2010 Journal of Urology 184, pp. 1816-1822.

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