TY - JOUR
T1 - Active stone removal is a safe option for ocotogenarians and nonagenarians with nephrolithiasis
AU - Eredics, Klaus
AU - Drerup, Martin
AU - Özsoy, Mehmet
AU - Wehrberger, Clemens
AU - Lenz, Matthias
AU - Ramesmayer, Christian
AU - Stolzlechner, Philipp
AU - Zanier, Johannes
AU - Falkensammer, Claudia E
AU - Handjiev, Ivan
AU - Wasserscheid, Andreas
AU - Seklehner, Stephan
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/3
Y1 - 2023/3
N2 - PURPOSE: To assess the contemporary in-hospital management of octogenarians and nonagenarians with renal calculi.MATERIAL AND METHODS: A multicentric retrospective evaluation of patients aged ≥ 80 years hospitalized with kidney stones between 01/2000 and 12/2019. Stone and patient related data were collected, including stone size and location, geriatric status and comorbidities. Surgical treatment patterns and outcome were assessed.RESULTS: A total of 299 patients (57% female) with kidney stones were analyzed. Mean age was 84.7 years. Patients were largely multimorbid (ASA ≥ 3 in 70%) and about 25% were classified as frail. Active stone treatment was performed in 65% and 35% were treated with urinary diversion (stent or nephrostomy). Prognostic factors for receiving an active stone treatment were age < 90 years, male sex, stone size and quantity, and performance status. Mean overall survival was 23.7 months and when stratified to treatment mean survival were 21 months after urinary diversion, 28 months after URS, 29 months after PCNL and 45 months after SWL.CONCLUSION: Age, frailty and performance-status as well as stone size and quantity are predictors for active stone treatment. Octogenarians and nonagenarians, who are considered fit for surgery, tend to live long enough to profit from active stone treatment.
AB - PURPOSE: To assess the contemporary in-hospital management of octogenarians and nonagenarians with renal calculi.MATERIAL AND METHODS: A multicentric retrospective evaluation of patients aged ≥ 80 years hospitalized with kidney stones between 01/2000 and 12/2019. Stone and patient related data were collected, including stone size and location, geriatric status and comorbidities. Surgical treatment patterns and outcome were assessed.RESULTS: A total of 299 patients (57% female) with kidney stones were analyzed. Mean age was 84.7 years. Patients were largely multimorbid (ASA ≥ 3 in 70%) and about 25% were classified as frail. Active stone treatment was performed in 65% and 35% were treated with urinary diversion (stent or nephrostomy). Prognostic factors for receiving an active stone treatment were age < 90 years, male sex, stone size and quantity, and performance status. Mean overall survival was 23.7 months and when stratified to treatment mean survival were 21 months after urinary diversion, 28 months after URS, 29 months after PCNL and 45 months after SWL.CONCLUSION: Age, frailty and performance-status as well as stone size and quantity are predictors for active stone treatment. Octogenarians and nonagenarians, who are considered fit for surgery, tend to live long enough to profit from active stone treatment.
KW - Elderly patients
KW - Geriatric patients
KW - Kidney stones
KW - Nephrolithiasis
KW - Nonagenarians
KW - Octogenarians
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=85147663926&partnerID=8YFLogxK
U2 - 10.1007/s00345-023-04304-3
DO - 10.1007/s00345-023-04304-3
M3 - Journal article
C2 - 36754879
SN - 0724-4983
VL - 41
SP - 849
EP - 856
JO - World Journal of Urology
JF - World Journal of Urology
IS - 3
ER -