Trends in Upper Tract Stone Disease in England: Evidence from the Hospital Episodes Statistics Database

Abstract

Aims: The study aimed to determine the current trends in urolithiasis-related admissions and associated interventions in England between 2006/2007 and 2013/2014 utilizing Hospital Episode Statistics (HES) online data.

Material and methods: Data was extracted from the online HES data set for each year from 2006/2007 to 2013/2014 inclusive. Admissions and procedural interventions were identified from their corresponding OPCS-4 and ICD-10 codes.

Results: Finished consultant episodes (FCEs) for urolithiasis have increased by 20% over the last 7 years, with 93,039 FCEs in the year 2013/2014. Based on English population statistics, the lifetime prevalence of urolithiasis based on hospital-related admission/intervention data for 2013/2014 is 14%. The biggest increases were seen in those aged ≥75 years (up by 51%, n = 2,853). Total interventions have increased from 28,624 to 42,068, with increased rates of shock wave lithotripsy (26%), ureteroscopy (URS; 86%) and percutaneous nephrolithotomy (149%). Emergency URS procedures have increased by 38%. Day-case rates for ureteric and renal URS, in 2013/2014, were 22 and 21%, respectively.

Conclusions: Over the last 7 years, there is a rising prevalence of kidney stone disease with associated increase in the number of interventions related to it. Both elective and emergency URS procedures are increasing, with a rising trend for day-case URS. Similar trends are seen worldwide and future resource planning for urolithiasis is needed to match the increase in demand.

Keywords: Lithotripsy; PCNL; Trend; Ureteroscopy; Urolithiasis.