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UPJ INSIGHT Neighborhood Social Vulnerability Impacts Quality of Life in Kidney Stone Patients
By: David Y. Song, BS, University of Rochester Medical Center, New York; Carl A. Ceraolo, MD, University of Rochester Medical Center, New York; Karen M. Doersch, MD, University of Rochester Medical Center, New York; Timothy D. Campbell, MD, University of Rochester Medical Center, New York; Christopher Wanderling, MD, University of Rochester Medical Center, New York; Nathan Schuler, MS, University of Rochester Medical Center, New York; Rajat K. Jain, MD, University of Rochester Medical Center, New York; Scott O. Quarrier, MD, University of Rochester Medical Center, New York | Posted on: 19 Jan 2024
Song DY, Ceraolo CA, Doersch KM, et al. Neighborhood social vulnerability impacts quality of life in kidney stone patients. Urol Pract. 2024;11(1):179-185.
Study Need and Importance
Kidney stones have a significant impact on quality of life (QoL). Our study examined the association between social vulnerability as measured by the Social Vulnerability Index and QoL of kidney stone patients. This is essential given the growing awareness of the role of socioeconomic status in the onset and progression of kidney stones. Identifying the impact of social vulnerability on QoL can help health care providers tailor interventions for vulnerable populations.
What We Found
Our analysis of 1718 kidney stone patients revealed a significant association between social vulnerability and QoL. Patients in areas with high Social Vulnerability Index reported significantly lower QoL scores across a variety of domains, including social impact, emotional impact, impact of illness, and vitality. Younger age, female gender, and higher number of comorbidities were identified as independent predictors of lower QoL scores. Notably, non-White race and Latinx ethnicity were not significantly associated with QoL scores in our multivariate analysis (Table).
Table. Multivariate Linear Regression for Predictors of Health-Related Quality of Life
| Variable | β | CI | P value |
|---|---|---|---|
| Age at visit (y) | 0.28 | (0.20 to 0.36) | < .001 |
| Sex (female) | −9.00 | (−11.16 to −6.85) | < .001 |
| Race (non-White) | −1.11 | (−5.61 to 3.38) | .626 |
| Ethnicity (Latinx) | −1.10 | (−5.31 to 3.11) | .609 |
| No. of comorbidities | −2.98 | (−4.08 to −1.88) | < .001 |
| SVI (highest quartile) | −5.96 | (−10.44 to −1.48) | .009 |
| Abbreviations: HRQOL, health-related quality of life; SVI, Social Vulnerability Index. | |||
Limitations
Our study has several limitations, including its retrospective design, which limit our ability to establish a causal relationship. Our sample consisted primarily of English-speaking patients from a single kidney stone clinic, which limits the generalizability of our results. Additionally, reliance on survey-based data collection may introduce recall bias, and electronic distribution may introduce selection bias among respondents.
Interpretation for Patient Care
Our results highlight the deleterious impact of high social vulnerability on the QoL of patients with kidney stones. Recognition of social determinants of health, especially social vulnerability, is important in patient care. Appropriate intervention and support programs for vulnerable populations are needed. Furthermore, our results challenge the assumption that race/ethnicity alone is an important determinant of QoL in patients with kidney stones, emphasizing the need to focus on broader socioeconomic factors when assessing a patient’s health.
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