Presented by: Scott Quarrier MD
University of Rochester Medical Center

Introduction

Socioeconomic factors contribute to kidney stone prevalence, impacting the quality of life of affected individuals. The Social Vulnerability Index (SVI), developed by the CDC using US census data, assesses various socioeconomic factors to determine the level of vulnerability within a particular community. This study aims to explore the association between social vulnerability and patient-reported quality of life in kidney stone patients, utilizing the Wisconsin Stone Quality of Life Questionnaire (WISQOL), a validated disease-specific questionnaire.

Materials

A retrospective review was conducted for new urolithiasis patients who completed the WISQOL questionnaire upon their initial visit to a kidney stone clinic between 1/16/2019, and 4/13/2023. Patients were categorized into quartiles based on their census tract SVI scores, representing varying levels of vulnerability (quartile 1: least vulnerable, quartile 4: most vulnerable). Statistical analysis using the one-way ANOVA test in Python3 was performed to assess the disparity in WISQOL total score and subscores.

Results

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The study included a total of 1696 patients, distributed across quartiles 1-4 as follows: 662 (39%), 639 (38%), 291 (17%), and 104 (6%). WISQOL total scores decreased (indicating worsening QOL) as social vulnerability increased, with a statistically significant difference observed among the SVI quartiles (p<0.001). Several SVI sub-scores showed negative correlations with lower WISQOL scores, including socioeconomic factors (p<0.001), minority status and language (p<0.01), housing type and transportation (p<0.05), and household composition and disability (p<0.01). Furthermore, significant differences were noted in all WISQOL subdomains between the SVI quartiles, encompassing social impact, emotional impact, disease impact, and impact on vitality (p<0.01).

Conclusion

Our findings highlight the association between neighborhood-level socioeconomic vulnerability and diminished quality of life among new kidney stone patients attending a kidney stone clinic. The incorporation of SVI measures may prove valuable for clinicians and researchers in identifying patients who are most likely to benefit from preventive and clinical interventions.

Funding

None

Lead Authors

David Song,
University of Rochester School of Medicine

Co-Authors

Karen Doersch, MD
University of Rochester Medical Center

Timothy Campbell, MD
University of Rochester Medical Center

Christopher Wanderling, MD
University of Rochester Medical Center

Nathan Schuler,
University of Rochester Medical Center

Rajat Jain, MD
University of Rochester Medical Center

Scott Quarrier, MD
University of Rochester Medical Center