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首页> 外文期刊>BJU international >One-stop clinic for ketamine-associated uropathy: Report on service delivery model, patients' characteristics and non-invasive investigations at baseline by a cross-sectional study in a prospective cohort of 318 teenagers and young adults
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One-stop clinic for ketamine-associated uropathy: Report on service delivery model, patients' characteristics and non-invasive investigations at baseline by a cross-sectional study in a prospective cohort of 318 teenagers and young adults

机译：氯胺酮相关性尿病的一站式诊所：在一项针对318名青少年的前瞻性队列研究中，通过横断面研究报告了基线时的服务提供模式，患者特征和非侵入性检查

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Objective To describe a service delivery model and report the baseline characteristics of patients investigated by a non-invasive approach for ketamine-associated uropathy. Patients and Methods This was a cross-sectional study in a prospective cohort of patients who attended their first visit and underwent non-invasive investigations at a dedicated centre to treat ketamine-associated uropathy in Hong Kong from December 2011 to July 2013. Data on demographics, illicit ketamine use, symptoms scores and voiding function parameters at baseline were prospectively collected. Differences between active abusers and ex-abusers, and risk factors for the most symptomatic group were investigated by univariate and multivariate analysis. Results In all, 318 patients completed the non-invasive assessment at their first visit and were eligible for inclusion. In all, 174 were female and the mean (sd) age of the entire cohort was 24.4 (3.1) years. Patients had used ketamine for a mean (sd) period of 81 (36) months. The mean (sd) ketamine use per week was 18.5 (15.8) g. In all, 214 patients were active abusers while 104 were ex-abusers but had persistent lower urinary tract symptoms. The mean (sd) voided volume, bladder capacity, and bladder emptying efficiency were 111.5 (110) mL, 152.5 (126) mL and 73.3 (26.9)%, respectively. The ex-abusers had a lower symptom score (19.3 vs 24.1; P < 0.001), a larger voided volume (126 vs 85 mL; P < 0.001), and a larger bladder capacity (204.8 vs 126.7 mL; P < 0.001) compared with active abusers. Multivariate analysis found female gender was associated with a higher symptom score (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.35-4.23; P = 0.003) and a smaller voided volume (OR 1.9; 95% CI 1.1-3.3; P = 0.02). Ketamine taken (g/week) was another risk factor for a higher symptom score (OR 1.03; 95% CI 1.01-1.05; P = 0.002). Status of ex-abuser was the only protective factor associated with fewer symptoms, larger voided volume and bladder capacity. Conclusions An effective service model for recruiting patients with ketamine-associated uropathy is possible. With such a service model as a platform, further prospective studies are warranted to investigate the appropriate choice of treatment for this new clinical entity.
机译：目的描述非氯胺酮相关性尿毒症患者的服务提供模型并报告其基线特征。病人和方法这是一项横断面研究，对象是从2011年12月至2013年7月在香港治疗与氯胺酮相关的尿毒症的专门中心进行首次就诊并接受了非侵入性研究的患者。 ，前瞻性收集基线时的非法氯胺酮使用，症状评分和排尿功能参数。通过单因素和多因素分析，研究了积极滥用者和前滥用者之间的差异以及症状最严重的人群的危险因素。结果总共有318例患者在首次就诊时完成了无创评估，并符合纳入条件。共有174位女性，整个队列的平均（sd）年龄为24.4（3.1）岁。患者使用氯胺酮的平均（sd）期限为81（36）个月。每周平均（sd）氯胺酮使用量为18.5（15.8）g。共有214位患者是主动滥用者，而104位患者是前滥用者，但持续存在下尿路症状。平均（sd）排尿量，膀胱容量和膀胱排空效率分别为111.5（110）mL，152.5（126）mL和73.3（26.9）％。与之相比，前滥用者的症状评分较低（19.3 vs 24.1; P <0.001），排尿量较大（126 vs 85 mL; P <0.001），膀胱容量较大（204.8 vs 126.7 mL; P <0.001）。与积极的虐待者。多变量分析发现女性性别与较高的症状评分相关（奇数比[OR] 2.39; 95％置信区间[CI] 1.35-4.23; P = 0.003）和较小的排尿量（OR 1.9; 95％CI 1.1-3.3） ; P = 0.02）。服用氯胺酮（克/周）是症状评分更高的另一个危险因素（OR 1.03; 95％CI 1.01-1.05; P = 0.002）。前滥用者的状况是与更少的症状，更大的排尿量和膀胱容量相关的唯一保护因素。结论氯胺酮相关性尿毒症患者的有效服务模式是可能的。以这种服务模型为平台，有必要进行进一步的前瞻性研究，以研究针对这种新临床实体的治疗选择。

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