The impact of the COVID-19 pandemic on kidney stone management in a single-payer system
DOI:
https://doi.org/10.5489/cuaj.9223Keywords:
COVID-19, Renal colic, Shock wave lithotripsy, Ureteroscopy, PCNL, Stent, Nephrostomy, Kidney stones, Universal healthcareAbstract
INTRODUCTION: We examined the effects of the COVID-19 pandemic on the incidence of kidney stone acute care visits and interventions.
METHODS: We conducted a retrospective, population-based cohort study using linked administrative healthcare data in the province of Ontario, Canada. We included all patients who, between March 1, 2018, and September 30, 2021, presented to an emergency department (ED) or were admitted to hospital with renal colic (RC), as well as patients who underwent stenting, nephrostomy tube (NT) insertion, shockwave lithotripsy (SWL), ureteroscopy (URS), or percutaneous nephrolithotomy (PCNL). Using univariate and multivariable analyses, outcomes of interest were compared before and after the onset of COVID-19.
RESULTS: Our cohort included 149 006 unique patients; there were 74 994 pre- vs. 94 067 peri-COVID RC episodes (p=0.74). Peri-pandemic patients were more likely to be sicker, female, and from marginalized communities. Mean time from temporizing to definitive intervention increased in the first three months of the pandemic (17.9 vs. 32 days), but no statistically significant effect on the overall proportion of patients undergoing definitive intervention was observed. The onset of COVID-19 was associated with a 29.5% reduction in SWL and a 7.9% and 5.4% increase in URS and NT use, respectively. Hospital admissions for RC increased by 10.9%, while intensive care unit admissions decreased by 25% during the pandemic.
CONCLUSIONS: RC incidence and intervention rates were similar before and during the pandemic; however, patient demographics and morbidity differed. Understanding these trends can inform protocols for streamlining care in response to analogous strains on publicly funded healthcare systems.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:
- Post the Article on any Web site
- Translate or authorize a translation of the Article
- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.
The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.
You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.
The CUA also requires you to warrant the following:
- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
- That all individuals who have made a substantive contribution to the article are acknowledged;
- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
- That the Article does not libel or violate the privacy rights of any third party.
