University of Health Sciences, Erzurum Regional Training and Research Hospital, Department of Urology, Erzurum, Turkey.
University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Department of Urology, Istanbul, Turkey.
Actas Urol Esp (Engl Ed). 2022 Mar;46(2):114-121. doi: 10.1016/j.acuroe.2021.01.011. Epub 2022 Feb 17.
To combine non-contrast computerized tomography (NCCT)-based parameters with stone and patient characteristics that are already known to affect shock wave lithotripsy (SWL) success and assess this novel model's effectiveness in predicting SWL success for single ureteral stones in different locations.
Data of patients treated by SWL for a single ureteral stone between January 2017 and January 2019 were retrospectively reviewed. Demographic parameters of patients and stone characteristics were combined with NCCT-based parameters. NCCT-based parameters included the presence or absence of hydronephrosis, perinephric stranding, periureteral edema, diameter of the proximal ureter, ureteral wall thickness (UWT) at ureteral stone site. The logistic regression method was used for the development of a useful predictive model. Subsequently, the receiver operating curve was used to determine cut-off levels, and a scoring system was developed for prediction of SWL success.
Stone-free rate was 77,1% (267/346) in the entire cohort. Univariate analysis revealed that age, stone volume, density, perinephric stranding, diameter of proximal ureter, and UWT, were associated with SWL success. In multivariate analysis, proximal ureteral stone location, stone volume, density, and UWT were independent predictors of SWL success. The formula used during logistic regression analysis was: 1/[1 + exp {-8.856 + 0.008 (stone volume) + 0.002 (stone density) + 0.673 (UWT) + 1026 (proximal ureteral stone)}]. The scores of 0, 1, 2, 3 and 4 were associated with 97,8%, 83,4%, 60,8%, 33,2% and 11,1% success rates, respectively, in the prediction model based on these parameters.
We conclude that our model can facilitate decision-making for SWL treatment of ureteral stones in different locations.
结合已知影响体外冲击波碎石术（SWL）成功率的非增强计算机断层扫描（NCCT）参数与结石和患者特征，评估该新型模型在预测不同部位单发性输尿管结石 SWL 成功率方面的有效性。
回顾性分析 2017 年 1 月至 2019 年 1 月接受 SWL 治疗的单发性输尿管结石患者的数据。将患者的人口统计学参数和结石特征与 NCCT 基础参数相结合。NCCT 基础参数包括是否存在肾积水、肾周条纹状影、输尿管周围水肿、近端输尿管直径、输尿管结石部位的输尿管壁厚度（UWT）。采用逻辑回归法建立有用的预测模型。随后，采用受试者工作特征曲线确定截断值，并建立评分系统以预测 SWL 成功率。
在整个队列中，无石率为 77.1%（267/346）。单因素分析显示，年龄、结石体积、密度、肾周条纹状影、近端输尿管直径和 UWT 与 SWL 成功率相关。多因素分析显示，近端输尿管结石位置、结石体积、密度和 UWT 是 SWL 成功的独立预测因素。逻辑回归分析中使用的公式为：1/[1+exp{-8.856+0.008（结石体积）+0.002（结石密度）+0.673（UWT）+1026（近端输尿管结石）}]。基于这些参数的预测模型的评分分别为 0、1、2、3 和 4，其对应的成功率分别为 97.8%、83.4%、60.8%、33.2%和 11.1%。
我们得出结论，我们的模型可以为不同部位输尿管结石的 SWL 治疗决策提供帮助。
