University of Health Sciences Turkey, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine, Bursa, Turkey.
Am J Emerg Med. 2021 Nov;49:94-99. doi: 10.1016/j.ajem.2021.05.069. Epub 2021 Jun 1.
This study evaluates the effectiveness of CHOKAI and STONE scores in patients presenting to the emergency department with ureteral stones.
Patients over the age of 18 who were admitted to the emergency department with flank pain, groin pain, scrotal pain, and hematuria and who were performed non-contrast abdominal computed tomography (CT) for diagnostic imaging were included. The numeric pain, CHOKAI, and STONE scores of the patients were calculated. The effectiveness of these scoring systems in the presence of stones was examined.
A total of 105 patients were included in the study. In the analysis performed to investigate whether there was a difference between the numeric pain, STONE, and CHOKAI scores in terms of the presence of stones on CT, it was seen that the CHOKAI score was significantly different from the others (p < 0.001). A significant positive correlation was found between the CHOKAI score and stone size (r = 0.343, p < 0.001).When the cut-off value of the CHOKAI score was >7, the sensitivity was found to be 60.49%, and specificity was 83.33%. The cut-off value for the STONE score was >8 with a sensitivity of 70.37% and specificity of 58.33%. The corresponding area under curve values for the CHOHAI and STONE scores was 0.788 (p < 0.0001) and 0.615 (p = 0.087). Male sex, the CHOKAI, and STONE scores were the independent risk factors for ureteral stone. A significant positive correlation was found between the CHOKAI score and stone size (r = 0.343, p < 0.001).
The CHOKAI score has a higher performance than the STONE score in detecting the presence of ureteral stones.
The CHOKAI score has a higher performance than the STONE score in detecting the presence of ureteral stones. Especially in countries such as Turkey, where there are no specific racial differences, the STONE score may be diagnostically insufficient. The CHOKAI score shows the presence of the patient's stone and positively correlates with the size of the stone and the stone location.
In the functioning of the emergency department, it is important to make the differential diagnosis of patients quickly and provide effective treatment. The use of diagnostic scoring systems saves time for the emergency physician in the differential diagnosis phase and guides in terms of applying for possible additional imaging methods.
本研究评估了 CHOKAI 和 STONE 评分在因输尿管结石就诊急诊科的患者中的有效性。
纳入年龄在 18 岁以上、因腰痛、腹股沟痛、阴囊痛和血尿接受非增强腹部计算机断层扫描（CT）诊断成像的急诊科患者。计算患者的数字疼痛评分、CHOKAI 和 STONE 评分。检查这些评分系统在存在结石时的有效性。
共有 105 名患者纳入研究。在分析中，我们比较了 CT 上存在结石时数字疼痛评分、STONE 评分和 CHOKAI 评分之间的差异，结果发现 CHOKAI 评分与其他评分显著不同（p<0.001）。CHOKAI 评分与结石大小呈显著正相关（r=0.343，p<0.001）。当 CHOKAI 评分的截断值>7 时，敏感性为 60.49%，特异性为 83.33%。STONE 评分的截断值>8，敏感性为 70.37%，特异性为 58.33%。CHOKAI 和 STONE 评分的相应曲线下面积值分别为 0.788（p<0.0001）和 0.615（p=0.087）。男性、CHOKAI 评分和 STONE 评分是输尿管结石的独立危险因素。CHOKAI 评分与结石大小呈显著正相关（r=0.343，p<0.001）。
CHOKAI 评分在检测输尿管结石的存在方面优于 STONE 评分。
在检测输尿管结石的存在方面，CHOKAI 评分优于 STONE 评分。特别是在土耳其等没有特定种族差异的国家，STONE 评分可能在诊断上不够充分。CHOKAI 评分显示患者结石的存在，并与结石大小和结石位置呈正相关。
在急诊科的运作中，快速对患者进行鉴别诊断并提供有效治疗非常重要。诊断评分系统在鉴别诊断阶段为急诊医生节省时间，并指导是否需要申请额外的成像方法。
