Impact of Case Volume on Shock Wave Lithotripsy Outcomes: Data from the National Shock Wave Lithotripsy Database of New Zealand.

Alexander CE., Gowland S., Cadwallader J., Hopkins D., Reynard JM., Turney BW.

Purpose: To assess the impact of individual operator case volume on shock wave lithotripsy (SWL) treatment outcomes in more than 9000 stone cases over a 20-year period in New Zealand. Materials and Methods: Stone cases treated with SWL on the Mobile Medical Technology (MMT) vehicle between June 19, 1995, and December 1, 2014, were identified. Data collection was undertaken prospectively for patient, stone, and treatment characteristics, and retrospectively for treatment outcomes. Multivariate analysis using binary logistic regression was undertaken to assess whether radiographer stone case volume (stones/year) was an independent predictor of SWL success (stone free or clinically insignificant residual fragments ≤4 mm at follow-up). Results: Sixteen radiographers delivered treatment to the included cohort (9039 stone cases), with a median case volume (stones/year) of 73 (range: 37-197) and median total of 425 stones treated (range: 71-1721). The two radiographers with highest case volumes achieved the highest success rates. Radiographer case volume (stones/year) was independently associated with SWL success (odds ratio [OR]: 1.004, 95% confidence interval [CI]: 1.003-1.005, p 150 cases per year.

DOI

10.1089/end.2019.0122

Type

Journal article

Journal

J Endourol

Publication Date

08/2019

Volume

33

Pages

655 - 659

Keywords

kidney stones, lithotripsy, shock wave lithotripsy, urolithiasis, Adult, Aged, Cohort Studies, Databases, Factual, Female, Health Personnel, Hematoma, Hospitalization, Humans, Kidney Calculi, Lithotripsy, Logistic Models, Male, Middle Aged, Multivariate Analysis, New Zealand, Odds Ratio, Retrospective Studies, Sepsis, Treatment Outcome, Ureteral Calculi, Urinary Tract Infections, Urologists

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