Introduction & objectives:
\nExtracorporeal shock wave lithotripsy (ESWL) is a widely used, minimally invasive treatment for kidney stone disease (KSD) with a favourable safety profile. However, mortality associated with ESWL is rarely discussed. This systematic review aimed to evaluate the reported mortality following ESWL for KSD, identify contributing factors and highlight lessons learned to mitigate risk.<\/p>\n
Material & methods:
\nA systematic review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42024606297). MEDLINE, Embase, and the Cochrane Library were searched from inception to May 2025 for studies reporting mortality following ESWL for KSD. Data on patient characteristics, procedural factors, complications, and causes of death were extracted from eligible studies. Due to heterogeneity, a descriptive synthesis was performed.<\/p>\n
Results:
\nTen studies published between 1989 and 2023 were included, encompassing 25,947 patients undergoing ESWL. Twelve ESWL-associated deaths were identified. Mortality predominantly occurred in older, comorbid patients, frequently with cardiovascular disease or anticoagulant\/antiplatelet use. The most common cause of death following ESWL was haemorrhagic shock due to retroperitoneal, perirenal, or subcapsular renal haemorrhage (n=5). Several fatal haemorrhagic events occurred despite temporary cessation of anticoagulant or antiplatelet therapy. Infectious causes represented the second most frequent cause of mortality, with patients developing urosepsis or septic shock (n=2). Other causes of death included myocardial infarction, cardiac arrest, and ruptured cerebral aneurysm. Deaths typically occurred within hours to days of treatment. Across included studies, advanced age, cardiovascular disease, frailty, anticoagulation use, and extremes of body mass index were the most commonly reported risk factors for mortality.<\/p>\n
Conclusion:
\nMortality following ESWL for KSD is extremely rare but can occur. Our study suggests safety can be improved by refining risk prediction, strict adherence to anticoagulation guidelines, and ensuring multidisciplinary oversight for complex patients. Further risk mitigation may be achieved by developing validated stratification tools and research-backed optimisation strategies.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & objectives: Extracorporeal shock wave lithotripsy (ESWL) is a widely used, minimally invasive treatment for kidney stone disease (KSD) with a favourable safety profile. However, mortality associated with ESWL is rarely discussed. This systematic review aimed to evaluate the … read more<\/a><\/p>","protected":false},"author":3,"featured_media":327,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-326","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/326","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/327"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=326"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=326"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=326"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}