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使用STONE评分预测亚洲急诊科的尿石症

Use of STONE Score to Predict Urolithiasis in an Asian Emergency Department.

作者信息

Ang Joo Shiang, Wong Su Yee Vanice, Ooi Chee Kheong

机构信息

Tan Tock Seng Hospital Emergency Department Singapore.

National University Health System Department of Internal Medicine Singapore.

出版信息

J Acute Med. 2022 Jun 1;12(2):53-59. doi: 10.6705/j.jacme.202206_12(2).0002.

DOI:10.6705/j.jacme.202206_12(2).0002
PMID:35860712
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9283116/
Abstract

BACKGROUND

The STONE score was developed to predict uncomplicated ureteral stones in patients so that they can be managed without imaging. Validation studies had been conducted previously but the results were varied. This study aims to investigate the utility of the STONE score in an emergency department in Singapore.

METHODS

We retrospectively analyzed the records of adult patients presenting with ureteric colic in the emergency department in 2015. STONE score as well as the proportion of urolithiasis diagnosed on advanced imaging in each STONE score group were calculated. Logistic regression was used to calculate the odds ratios (ORs) for the STONE score components in our study and compared with the ORs obtained in the original study. Measures of diagnostic accuracy for a high STONE score were also calculated.

RESULTS

753 cases were included in the final analysis. Among patients with a high STONE score, 66.7% had urolithiasis and 2.6% had significant alternative diagnoses. Compared to original studies, ORs for the STONE score components obtained for our study were different. From our study, the sensitivity of a high STONE score was 47.0%, specificity was 68.7%, positive predictive value was 66.7%, negative predictive value was 49.3%, positive likelihood ratio was 1.50, and negative likelihood ratio was 0.77.

CONCLUSION

The STONE score is not expected to perform well in Singapore based on our study. It should be used with caution in similar Asian populations.

摘要

背景

STONE评分旨在预测患者的单纯性输尿管结石，以便在无需影像学检查的情况下进行处理。此前已开展了验证研究，但结果各异。本研究旨在调查STONE评分在新加坡一家急诊科的实用性。

方法

我们回顾性分析了2015年在急诊科因输尿管绞痛就诊的成年患者的记录。计算了STONE评分以及每个STONE评分组中通过高级影像学检查诊断出的尿石症比例。使用逻辑回归计算我们研究中STONE评分各组成部分的比值比（OR），并与原始研究中获得的OR进行比较。还计算了高STONE评分的诊断准确性指标。

结果

最终分析纳入了753例病例。在STONE评分高的患者中，66.7%患有尿石症，2.6%有重要的其他诊断。与原始研究相比，我们研究中获得的STONE评分各组成部分的OR有所不同。在我们的研究中，高STONE评分的敏感性为47.0%，特异性为68.7%，阳性预测值为66.7%，阴性预测值为49.3%，阳性似然比为1.50，阴性似然比为0.77。

结论

根据我们的研究，STONE评分在新加坡预计表现不佳。在类似的亚洲人群中应谨慎使用。