Altundağ İbrahim, Koçer Mehmet Taylan
Department of Emergency Medicine, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Selimiye, Tıbbiye Cd No:23, Üsküdar, 34668, Istanbul, Turkey.
Department of Emergency Medicine, Tekirdağ Dr. İsmail Fehmi Cumalioğlu City Hospital, İstiklal, Yemen Sokak No: 13, Süleymanpaşa, 59030, Tekirdağ, Turkey.
Urolithiasis. 2025 Aug 31;53(1):167. doi: 10.1007/s00240-025-01843-9.
Ureteral stones are a common cause of emergency department visits. However, their presentation in older adults may be atypical. As the global population ages, effective and low-risk diagnostic strategies are increasingly vital to improve patient outcomes, reduce radiation exposure, and lower healthcare costs. This retrospective cohort study conducted between January 2020 and December 2024. We aimed to assess the diagnostic performance of the STONE and New STONE scores in detecting ureteral stones among patients aged 60 and older presenting with flank pain. A total of 161 patients who underwent abdominal computed tomography (CT) were included, with ureteral stones detected in 48.4%. Patients with stones had significantly higher STONE (8.7 ± 2.0 vs. 6.1 ± 1.9) and New STONE scores (5.0 ± 1.9 vs. 2.7 ± 1.6) compared to patients without stone (p < 0.001 for both). The STONE score showed an AUC of 0.830 and the New STONE score 0.829. A cut-off STONE score > 5 yielded 97.4% sensitivity, while a cut-off > 9 provided 88.0% specificity. For the New STONE score, a cut-off > 3 offered 89.7% sensitivity, and a cut-off > 6 showed 97.6% specificity. Both scores demonstrated reliable diagnostic accuracy in elderly patients. The STONE score favored sensitivity, while the New STONE score favored specificity. Our findings suggest that these scoring systems may support imaging decision-making and contribute to reducing unnecessary CT exposure and healthcare costs in older adults with suspected ureteral stones.
输尿管结石是急诊就诊的常见原因。然而，它们在老年人中的表现可能不典型。随着全球人口老龄化，有效且低风险的诊断策略对于改善患者预后、减少辐射暴露以及降低医疗成本变得越来越重要。这项回顾性队列研究在2020年1月至2024年12月期间进行。我们旨在评估STONE和新STONE评分在检测60岁及以上出现侧腹痛的患者输尿管结石中的诊断性能。总共纳入了161例行腹部计算机断层扫描（CT）的患者，其中48.4%检测到输尿管结石。与无结石患者相比，有结石患者的STONE评分（8.7±2.0对6.1±1.9）和新STONE评分（5.0±1.9对2.7±1.6）显著更高（两者p<0.001）。STONE评分的曲线下面积（AUC）为0.830，新STONE评分为0.829。STONE评分>5时灵敏度为97.4%，而>9时特异性为88.0%。对于新STONE评分，>3时灵敏度为89.7%，>6时特异性为97.6%。两个评分在老年患者中均显示出可靠的诊断准确性。STONE评分更倾向于灵敏度，而新STONE评分更倾向于特异性。我们的研究结果表明，这些评分系统可能有助于影像决策，并有助于减少疑似输尿管结石的老年人不必要的CT暴露和医疗成本。
