Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Institute of Urology, Anhui Medical University, Hefei, China.
Int Urol Nephrol. 2024 May;56(5):1585-1593. doi: 10.1007/s11255-023-03847-z. Epub 2023 Dec 16.
Kidney stones account for a high proportion of urological emergencies. The main objective of this paper is to evaluate the predictive ability of five scoring systems for overall stone-free status and postoperative complications after percutaneous nephrolithotomy and retrograde ureteroscopy.
This study retrospectively analysed 312 cases of kidney stone patients between January 2021 and May 2022 at our centre. Multivariate logistic regression as well as ROC curves were applied to determine the ability to evaluate each scale to predict stone-free rates and postoperative complications.
179 patients have undergone PCNL. After multivariate logistic regression, the S.T.O.N.E score and history of ipsilateral renal surgery were predictive of stone-free status, and the predictive power of the S.T.O.N.E score was higher than that of history of ipsilateral renal surgery. Grade 1 complications were considered to be related to Guy's score and grade 2 complications were considered to be related to history of diabetes mellitus. 133 patients have undergone f-URS. After multivariate logistic regression analysis, the modified S-ReSC score, RUSS score, and R.I.R.S score were predictive of stone-free status, with the R.I.R.S score being the strongest predictor. Evidence of grade 2 complications was considered to be related to abnormal renal function.
For PCNL, the S.T.O.N.E score had the best efficacy in predicting stone-free status, and the Guy's score had the best efficacy in predicting postoperative complications; for f-URS, the R.I.R.S score had the best efficacy in predicting stone-free status, and no scoring system predicted postoperative complications.
肾结石占泌尿外科急症的很大比例。本文的主要目的是评估五种评分系统对经皮肾镜取石术和逆行输尿管镜碎石术术后结石清除状态和术后并发症的预测能力。
本研究回顾性分析了 2021 年 1 月至 2022 年 5 月在我院治疗的 312 例肾结石患者。采用多变量逻辑回归和 ROC 曲线来确定每个评分系统评估结石清除率和术后并发症的能力。
179 例患者接受了 PCNL。多变量逻辑回归后，S.T.O.N.E 评分和同侧肾脏手术史是结石清除状态的预测因素，S.T.O.N.E 评分的预测能力高于同侧肾脏手术史。1 级并发症与 Guy 评分有关，2 级并发症与糖尿病史有关。133 例患者接受了 f-URS。多变量逻辑回归分析后，改良 S-ReSC 评分、RUSS 评分和 R.I.R.S 评分与结石清除状态相关，其中 R.I.R.S 评分的预测能力最强。2 级并发症的证据与肾功能异常有关。
对于 PCNL，S.T.O.N.E 评分在预测结石清除状态方面效果最佳，Guy 评分在预测术后并发症方面效果最佳；对于 f-URS，R.I.R.S 评分在预测结石清除状态方面效果最佳，没有评分系统预测术后并发症。
