ConceptSet

Oral Zonisamide, Drug Exposure


Variable Name

rx_zonisamide-oral

Refreshed Date

2021-02

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Concept set to identify patients with an exposure to oral zonisamide.


Variable Status

Funder(s)

Provenance

Outcomes of Children with Kidney Stones: Retrospective Cohort Study

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Study Variable Applications

Pediatric KIDney Stone (PKIDS) Care Improvement Network
Study Dates:2019-11 - 2021-10Sponsor Site:PEDSnet Data Coordinating Center
Founded in 2019, PKIDS is a learning health system with a mission to improve outcomes for children with kidney stone disease through collaborative patient-centered research and is comprised of patients, caregivers, and clinicians at 26 pediatric healthcare systems in North America. PKIDS has an established infrastructure for collaborative research and is currently engaged in clinical trials and observational studies funded by PCORI, NIH, and industry. The PKIDS Engagement Core, including the PFP, ensures the co-production of all network activities by key stakeholders, particularly adolescents with kidney stones and their caregivers. Eight PKIDS sites have additional membership in PEDSNet, a robust CDRN supporting pediatric learning health.

Published Research Applications

Ureteral Stent Placement is Associated with Higher Post-Operative Emergency Department Visits and Opioid Prescriptions for Youth Having Ureteroscopy or Shockwave Lithotripsy
Published:2023-02-22Journal:Journal of Urology
**Purpose** Little is known about the impact of ureteral stents on youth having stone surgery. We evaluated the association of ureteral stent placement before or concurrent with ureteroscopy and shock wave lithotripsy with emergency department visits and opioid prescriptions among pediatric patients. **Materials and methods** We conducted a retrospective cohort study of individuals aged 0-24 years who underwent ureteroscopy or shock wave lithotripsy from 2009-2021 at 6 hospitals in PEDSnet, a research network that aggregates electronic health record data from children's health systems in the United States. The exposure, primary ureteral stent placement, was defined as a stent placed concurrent with or within 60 days before ureteroscopy or shock wave lithotripsy. Associations between primary stent placement and stone-related ED visits and opioid prescriptions within 120 days of the index procedure were evaluated with mixed-effects Poisson regression. **Results** Two-thousand ninety-three patients (60% female; median age 15 years, IQR 11-17) had 2,477 surgical episodes; 2,144 were ureteroscopy and 333 were shock wave lithotripsy. Primary stents were placed in 1,698 (79%) ureteroscopy episodes and 33 (10%) shock wave lithotripsy episodes. Ureteral stents were associated with a 33% higher rate of emergency department visits (IRR 1.33; 95% CI 1.02-1.73) and a 30% higher rate of opioid prescriptions (IRR 1.30; 95% CI 1.10-1.53). The magnitudes of both associations were greater for shock wave lithotripsy. Results were similar for age <18 and were lost when restricted to concurrent stent placement. **Conclusions** Primary ureteral stent placement was associated with more frequent emergency department visits and opioid prescriptions, driven by pre-stenting. These results support elucidating situations where stents are not necessary for youth with nephrolithiasis.

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a CC-BY Attribution 4.0 License.
Except where otherwised noted, this item's license is described as a CC-BY Attribution 4.0 License.