Department of Emergency Medicine, Beylikduzu State Hospital, Istanbul, Turkey.
Department of Emergency Medicine, Kastamonu State Hospital, Kastamonu, Turkey.
Am J Emerg Med. 2021 Sep;47:158-163. doi: 10.1016/j.ajem.2021.03.073. Epub 2021 Mar 27.
BACKGROUND/AIM: Computed tomography (CT) is generally used for ureteral stone diagnosis. Unnecessary imaging use should be reduced to prevent increased radiation exposure and lower costs. For this reason, scoring systems that evaluate the risk of ureteral stones have been developed. In this study, we aimed to investigate the diagnostic accuracy of the modified STONE score (MSS) and its ability to predict ureteral stones.
The research was conducted as a multi-center, prospective and observational study. Patients aged 18 and over who presented to EDs with complaints of flank pain and who received a CT were included. Patients were divided into two groups based on the presence or absence of stones, and the categories of the MSS were determined. The ability of the MSS to predict the ureteral stone and its diagnostic accuracy were calculated.
The median age (min/max) of the 367 study patients was 37 (18/91), and 244 (66.5%) were male. A ureteral stone was present in 228 (73.0%) patients. Male gender, previous stone history, duration of pain less than 6 h, presence of hematuria, and CRP value below 0.5 mg/dL were significantly more common in the group with stones. The prevalence of ureter stones in the MSS high-risk group was 96.0%. The area under the receiver operating characteristic curve and sensitivity of the MSS was 0.903 and 0.81, respectively.
The modified STONE score has high diagnostic performance in suspected urinary stone cases. This scoring system can assist clinicians with radiation reducing decision-making.
背景/目的：计算机断层扫描（CT）通常用于诊断输尿管结石。为了降低辐射暴露和降低成本，应减少不必要的影像学检查。为此，已经开发了评估输尿管结石风险的评分系统。本研究旨在探讨改良 STONE 评分（MSS）的诊断准确性及其预测输尿管结石的能力。
该研究是一项多中心、前瞻性和观察性研究。纳入因腰痛就诊于急诊科并接受 CT 检查的年龄在 18 岁及以上的患者。根据是否存在结石将患者分为两组，并确定 MSS 的类别。计算 MSS 预测输尿管结石的能力及其诊断准确性。
367 例研究患者的中位年龄（最小/最大）为 37 岁（18/91），其中 244 例（66.5%）为男性。228 例（73.0%）患者存在输尿管结石。男性、既往结石史、疼痛持续时间<6 小时、血尿存在和 CRP 值<0.5mg/dL 在结石组中更为常见。MSS 高危组的输尿管结石患病率为 96.0%。MSS 的受试者工作特征曲线下面积和敏感性分别为 0.903 和 0.81。
改良 STONE 评分在疑似尿路结石病例中具有较高的诊断性能。该评分系统可以帮助临床医生做出减少辐射的决策。
