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External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2–4 cm
Our primary aim is to perform the external validation of the current scoring systems in predicting stone-free status (SFS) after retrograde intrarenal surgery (RIRS) for renal stones 2–4 cm and develop a novel scoring system by re-examining possible predictive factors related to SFS. Patients who un...
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| Published in: | Actas urológicas españolas (English ed.) 2023-05, Vol.47 (4), p.211-220 |
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| creator | Polat, S. Danacioglu, Y.O. Yarimoglu, S. Soytas, M. Erdogan, A. Teke, K. Degirmenci, T. Tasci, A.I. |
| description | Our primary aim is to perform the external validation of the current scoring systems in predicting stone-free status (SFS) after retrograde intrarenal surgery (RIRS) for renal stones 2–4 cm and develop a novel scoring system by re-examining possible predictive factors related to SFS.
Patients who underwent RIRS due to renal stones with a cumulative stone diameter of 2–4 cm between January 2017 and March 2021 were retrospectively screened. Residual stones ≤2 mm were defined as clinically insignificant, and these cases were considered to have SFS. Possible predictive factors related to SFS were examined using the multivariate logistic regression analysis. A nomogram and a scoring system were developed using independent predictive variables. The prediction ability of the previous and the new scoring system were evaluated with the ROC analysis.
The existing scoring systems were found to be insufficient in predicting SFS (AUC |
| doi_str_mv | 10.1016/j.acuroe.2022.08.015 |
| format | article |
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Patients who underwent RIRS due to renal stones with a cumulative stone diameter of 2–4 cm between January 2017 and March 2021 were retrospectively screened. Residual stones ≤2 mm were defined as clinically insignificant, and these cases were considered to have SFS. Possible predictive factors related to SFS were examined using the multivariate logistic regression analysis. A nomogram and a scoring system were developed using independent predictive variables. The prediction ability of the previous and the new scoring system were evaluated with the ROC analysis.
The existing scoring systems were found to be insufficient in predicting SFS (AUC < 0.660 for all). The independent predictors of SFS were identified as stone surface area (OR: 0.991, p < 0.001), stone density (OR: 0.998, p < 0.001), number of stones (OR: 0.365, p = 0.033), and stone localization (p = 0.037). Using these predictive markers, a new scoring system with a score ranging between 4 and 15 was developed. The AUC value for this scoring system was 0.802 (0.734−0.870).
The RUSS, S-ReSC and R.I.R.S. scoring systems and Ito’s nomogram failed to predict SFS in stones >2 cm. The SFS predictive ability of our new scoring system was higher in >2 cm stones compared to the other scoring systems.
Nuestro objetivo principal es realizar la validación externa de los sistemas de puntuación actuales para predecir el estado libre de cálculos (ELC) después de la cirugía intrarrenal retrógrada (CRIR) para cálculos renales de 2−4 cm y desarrollar un nuevo sistema de puntuación reexaminando los posibles factores predictivos relacionados con el ELC.
Se evaluaron retrospectivamente los pacientes que recibieron CRIR para el tratamiento de cálculos renales con diámetro acumulado de 2−4 cm, entre enero de 2017 y marzo de 2021. Los cálculos residuales ≤2 mm se definieron como clínicamente insignificantes, y estos casos se consideraron como ELC. Se examinaron los posibles factores predictivos relacionados con el ELC mediante el análisis de regresión logística multivariante. Se elaboró un nomograma y se creó un sistema de puntuación utilizando variables predictivas independientes. Mediante el análisis ROC se evaluó la capacidad de predicción de los sistemas de puntuación actuales y del recién desarrollado.
Los sistemas de puntuación existentes resultaron insuficientes para predecir el ELC (AUC < 0,660 en todos los casos). Se identificaron como predictores independientes del ELC el área de superficie (OR: 0,991, p < 0,001), la densidad (OR: 0,998, p < 0,001), el número (OR: 0,365, p = 0,033) y la localización de los cálculos (p = 0,037). Utilizando estos marcadores predictivos, se desarrolló un nuevo sistema de puntuación cuyos resultados oscilan entre 4 y 15. El valor AUC de este sistema de puntuación fue de 0,802 (0,734–0,870).
Los sistemas de puntuación RUSS, S-ReSC y R.I.R.S. y el nomograma de Ito no lograron predecir el ELC en cálculos de >2 cm. Nuestro nuevo sistema de puntuación tuvo una capacidad predictiva del ELC mayor en cálculos de >2 cm, en comparación con los otros sistemas de puntuación.]]></description><identifier>ISSN: 2173-5786</identifier><identifier>EISSN: 2173-5786</identifier><identifier>DOI: 10.1016/j.acuroe.2022.08.015</identifier><identifier>PMID: 36333221</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Cálculos renales grandes ; Flexible ureterorenoscopy ; Humans ; Kidney Calculi - surgery ; Large renal stones ; Lithotripsy ; Litotricia ; Nomograms ; Retrospective Studies ; ROC Curve ; Scoring system ; Sistema de puntuación ; Treatment Outcome ; Ureterorrenoscopia flexible ; Urolithiasis ; Urolitiasis</subject><ispartof>Actas urológicas españolas (English ed.), 2023-05, Vol.47 (4), p.211-220</ispartof><rights>2022 AEU</rights><rights>Copyright © 2022. Published by Elsevier España, S.L.U.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2071-a025c484b6871e638cb6ece4bf2151f9f190bdd4da122a149c6a94b06302c9a63</citedby><cites>FETCH-LOGICAL-c2071-a025c484b6871e638cb6ece4bf2151f9f190bdd4da122a149c6a94b06302c9a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36333221$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Polat, S.</creatorcontrib><creatorcontrib>Danacioglu, Y.O.</creatorcontrib><creatorcontrib>Yarimoglu, S.</creatorcontrib><creatorcontrib>Soytas, M.</creatorcontrib><creatorcontrib>Erdogan, A.</creatorcontrib><creatorcontrib>Teke, K.</creatorcontrib><creatorcontrib>Degirmenci, T.</creatorcontrib><creatorcontrib>Tasci, A.I.</creatorcontrib><title>External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2–4 cm</title><title>Actas urológicas españolas (English ed.)</title><addtitle>Actas Urol Esp (Engl Ed)</addtitle><description><![CDATA[Our primary aim is to perform the external validation of the current scoring systems in predicting stone-free status (SFS) after retrograde intrarenal surgery (RIRS) for renal stones 2–4 cm and develop a novel scoring system by re-examining possible predictive factors related to SFS.
Patients who underwent RIRS due to renal stones with a cumulative stone diameter of 2–4 cm between January 2017 and March 2021 were retrospectively screened. Residual stones ≤2 mm were defined as clinically insignificant, and these cases were considered to have SFS. Possible predictive factors related to SFS were examined using the multivariate logistic regression analysis. A nomogram and a scoring system were developed using independent predictive variables. The prediction ability of the previous and the new scoring system were evaluated with the ROC analysis.
The existing scoring systems were found to be insufficient in predicting SFS (AUC < 0.660 for all). The independent predictors of SFS were identified as stone surface area (OR: 0.991, p < 0.001), stone density (OR: 0.998, p < 0.001), number of stones (OR: 0.365, p = 0.033), and stone localization (p = 0.037). Using these predictive markers, a new scoring system with a score ranging between 4 and 15 was developed. The AUC value for this scoring system was 0.802 (0.734−0.870).
The RUSS, S-ReSC and R.I.R.S. scoring systems and Ito’s nomogram failed to predict SFS in stones >2 cm. The SFS predictive ability of our new scoring system was higher in >2 cm stones compared to the other scoring systems.
Nuestro objetivo principal es realizar la validación externa de los sistemas de puntuación actuales para predecir el estado libre de cálculos (ELC) después de la cirugía intrarrenal retrógrada (CRIR) para cálculos renales de 2−4 cm y desarrollar un nuevo sistema de puntuación reexaminando los posibles factores predictivos relacionados con el ELC.
Se evaluaron retrospectivamente los pacientes que recibieron CRIR para el tratamiento de cálculos renales con diámetro acumulado de 2−4 cm, entre enero de 2017 y marzo de 2021. Los cálculos residuales ≤2 mm se definieron como clínicamente insignificantes, y estos casos se consideraron como ELC. Se examinaron los posibles factores predictivos relacionados con el ELC mediante el análisis de regresión logística multivariante. Se elaboró un nomograma y se creó un sistema de puntuación utilizando variables predictivas independientes. Mediante el análisis ROC se evaluó la capacidad de predicción de los sistemas de puntuación actuales y del recién desarrollado.
Los sistemas de puntuación existentes resultaron insuficientes para predecir el ELC (AUC < 0,660 en todos los casos). Se identificaron como predictores independientes del ELC el área de superficie (OR: 0,991, p < 0,001), la densidad (OR: 0,998, p < 0,001), el número (OR: 0,365, p = 0,033) y la localización de los cálculos (p = 0,037). Utilizando estos marcadores predictivos, se desarrolló un nuevo sistema de puntuación cuyos resultados oscilan entre 4 y 15. El valor AUC de este sistema de puntuación fue de 0,802 (0,734–0,870).
Los sistemas de puntuación RUSS, S-ReSC y R.I.R.S. y el nomograma de Ito no lograron predecir el ELC en cálculos de >2 cm. Nuestro nuevo sistema de puntuación tuvo una capacidad predictiva del ELC mayor en cálculos de >2 cm, en comparación con los otros sistemas de puntuación.]]></description><subject>Cálculos renales grandes</subject><subject>Flexible ureterorenoscopy</subject><subject>Humans</subject><subject>Kidney Calculi - surgery</subject><subject>Large renal stones</subject><subject>Lithotripsy</subject><subject>Litotricia</subject><subject>Nomograms</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Scoring system</subject><subject>Sistema de puntuación</subject><subject>Treatment Outcome</subject><subject>Ureterorrenoscopia flexible</subject><subject>Urolithiasis</subject><subject>Urolitiasis</subject><issn>2173-5786</issn><issn>2173-5786</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9UUtuFDEQbSEQiUJugJCXbGbwr38bJBQlgBSJDawtt1098ai7PZTdDbPLHTgIl-EEOQk1miFCLKiNS6VX7z3XK4qXgq8FF9Wb7dq6GSOsJZdyzZs1F-WT4lyKWq3Kuqme_tWfFZcpbTlVpVXZqufFmaqUUlKK8-LX9fcMONmBLXYI3uYQJxZ7lu-AkQLClFlyEcO0YWmfMoyJ2ckzDxiWR7RlU1xg-AfJcmQ7BB8cceQ4AesRgKHNQCQ96TKEjHGD1gMLU0ZLemQlzbgB3NOI7UiDPCT2LeQ7cjTOA00WOBH6YEc4EJEJ-XD_Qz_c_3Tji-JZb4cEl6f3ovhyc_356sPq9tP7j1fvbldO8lqsLJel043uqqYWUKnGdRU40F0vRSn6thct77zX3goprdCtq2yrO14pLl1rK3VRvD7y7jB-nSFlM4bkYBjsBHFORtZKllrxhhNUH6EOY0oIvdlhGC3ujeDmEKnZmmOk5hCp4Y2hSGnt1Ulh7kbwj0t_AiTA2yMA6J9LADTJ0cEcXR3BZeNj-L_Cb6Ylu54</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Polat, S.</creator><creator>Danacioglu, Y.O.</creator><creator>Yarimoglu, S.</creator><creator>Soytas, M.</creator><creator>Erdogan, A.</creator><creator>Teke, K.</creator><creator>Degirmenci, T.</creator><creator>Tasci, A.I.</creator><general>Elsevier España, S.L.U</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202305</creationdate><title>External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2–4 cm</title><author>Polat, S. ; Danacioglu, Y.O. ; Yarimoglu, S. ; Soytas, M. ; Erdogan, A. ; Teke, K. ; Degirmenci, T. ; Tasci, A.I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2071-a025c484b6871e638cb6ece4bf2151f9f190bdd4da122a149c6a94b06302c9a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cálculos renales grandes</topic><topic>Flexible ureterorenoscopy</topic><topic>Humans</topic><topic>Kidney Calculi - surgery</topic><topic>Large renal stones</topic><topic>Lithotripsy</topic><topic>Litotricia</topic><topic>Nomograms</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Scoring system</topic><topic>Sistema de puntuación</topic><topic>Treatment Outcome</topic><topic>Ureterorrenoscopia flexible</topic><topic>Urolithiasis</topic><topic>Urolitiasis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Polat, S.</creatorcontrib><creatorcontrib>Danacioglu, Y.O.</creatorcontrib><creatorcontrib>Yarimoglu, S.</creatorcontrib><creatorcontrib>Soytas, M.</creatorcontrib><creatorcontrib>Erdogan, A.</creatorcontrib><creatorcontrib>Teke, K.</creatorcontrib><creatorcontrib>Degirmenci, T.</creatorcontrib><creatorcontrib>Tasci, A.I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Actas urológicas españolas (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Polat, S.</au><au>Danacioglu, Y.O.</au><au>Yarimoglu, S.</au><au>Soytas, M.</au><au>Erdogan, A.</au><au>Teke, K.</au><au>Degirmenci, T.</au><au>Tasci, A.I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2–4 cm</atitle><jtitle>Actas urológicas españolas (English ed.)</jtitle><addtitle>Actas Urol Esp (Engl Ed)</addtitle><date>2023-05</date><risdate>2023</risdate><volume>47</volume><issue>4</issue><spage>211</spage><epage>220</epage><pages>211-220</pages><issn>2173-5786</issn><eissn>2173-5786</eissn><abstract><![CDATA[Our primary aim is to perform the external validation of the current scoring systems in predicting stone-free status (SFS) after retrograde intrarenal surgery (RIRS) for renal stones 2–4 cm and develop a novel scoring system by re-examining possible predictive factors related to SFS.
Patients who underwent RIRS due to renal stones with a cumulative stone diameter of 2–4 cm between January 2017 and March 2021 were retrospectively screened. Residual stones ≤2 mm were defined as clinically insignificant, and these cases were considered to have SFS. Possible predictive factors related to SFS were examined using the multivariate logistic regression analysis. A nomogram and a scoring system were developed using independent predictive variables. The prediction ability of the previous and the new scoring system were evaluated with the ROC analysis.
The existing scoring systems were found to be insufficient in predicting SFS (AUC < 0.660 for all). The independent predictors of SFS were identified as stone surface area (OR: 0.991, p < 0.001), stone density (OR: 0.998, p < 0.001), number of stones (OR: 0.365, p = 0.033), and stone localization (p = 0.037). Using these predictive markers, a new scoring system with a score ranging between 4 and 15 was developed. The AUC value for this scoring system was 0.802 (0.734−0.870).
The RUSS, S-ReSC and R.I.R.S. scoring systems and Ito’s nomogram failed to predict SFS in stones >2 cm. The SFS predictive ability of our new scoring system was higher in >2 cm stones compared to the other scoring systems.
Nuestro objetivo principal es realizar la validación externa de los sistemas de puntuación actuales para predecir el estado libre de cálculos (ELC) después de la cirugía intrarrenal retrógrada (CRIR) para cálculos renales de 2−4 cm y desarrollar un nuevo sistema de puntuación reexaminando los posibles factores predictivos relacionados con el ELC.
Se evaluaron retrospectivamente los pacientes que recibieron CRIR para el tratamiento de cálculos renales con diámetro acumulado de 2−4 cm, entre enero de 2017 y marzo de 2021. Los cálculos residuales ≤2 mm se definieron como clínicamente insignificantes, y estos casos se consideraron como ELC. Se examinaron los posibles factores predictivos relacionados con el ELC mediante el análisis de regresión logística multivariante. Se elaboró un nomograma y se creó un sistema de puntuación utilizando variables predictivas independientes. Mediante el análisis ROC se evaluó la capacidad de predicción de los sistemas de puntuación actuales y del recién desarrollado.
Los sistemas de puntuación existentes resultaron insuficientes para predecir el ELC (AUC < 0,660 en todos los casos). Se identificaron como predictores independientes del ELC el área de superficie (OR: 0,991, p < 0,001), la densidad (OR: 0,998, p < 0,001), el número (OR: 0,365, p = 0,033) y la localización de los cálculos (p = 0,037). Utilizando estos marcadores predictivos, se desarrolló un nuevo sistema de puntuación cuyos resultados oscilan entre 4 y 15. El valor AUC de este sistema de puntuación fue de 0,802 (0,734–0,870).
Los sistemas de puntuación RUSS, S-ReSC y R.I.R.S. y el nomograma de Ito no lograron predecir el ELC en cálculos de >2 cm. Nuestro nuevo sistema de puntuación tuvo una capacidad predictiva del ELC mayor en cálculos de >2 cm, en comparación con los otros sistemas de puntuación.]]></abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>36333221</pmid><doi>10.1016/j.acuroe.2022.08.015</doi><tpages>10</tpages></addata></record> |
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| source | Elsevier |
| subjects | Cálculos renales grandes Flexible ureterorenoscopy Humans Kidney Calculi - surgery Large renal stones Lithotripsy Litotricia Nomograms Retrospective Studies ROC Curve Scoring system Sistema de puntuación Treatment Outcome Ureterorrenoscopia flexible Urolithiasis Urolitiasis |
| title | External validation of the current scoring systems and derivation of a novel scoring system to predict stone free rates after retrograde intrarenal surgery in patients with cumulative stone diameter of 2–4 cm |
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