Assessing the predictive value of scoring systems for stone-free success outcomes in pediatric mini percutaneous nephrolithotomy: a comprehensive retrospective analysis.
Adem Altunkol, Ergün Alma, Hakan Anıl, Mert Hamza Özbilen, Buğra Aksay, Mehmet Eflatun Deniz
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引用次数: 0
Abstract
Kidney stone disease is relatively uncommon in pediatric populations, although its incidence has been steadily increasing in endemic regions. Mini-percutaneous nephrolithotomy (mini-PCNL), considered the most suitable approach for the treatment of large kidney stones, offers a minimally invasive option with fewer complications. This study evaluates the predictive accuracy of the STONE, Guy's Stone Score, and stone-kidney size (SKS) scoring systems in determining stone-free rates following pediatric mini-PCNL procedures. In this retrospective analysis, data were reviewed from 79 individuals younger than 18 who received mini-PCNL treatment from January 2021 to June 2024. Patients were evaluated as residual group and stone-free group. The diagnostic performance of the nomograms in detecting residual stones was evaluated using ROC analysis, and predictive factors for stone-free success were identified through logistic regression modeling. Guy's score (cut-off 1.5) had 79.3% sensitivity, 70% specificity, and AUC 0.817. The STONE score (cut-off 5.5) showed 69% sensitivity, 68% specificity, and AUC 0.741. SKS score (cut-off 3.5) resulted in 62.1% sensitivity, 78% specificity, and AUC 0.768. Logistic regression found stone size (OR: 1.137, p < 0.001) and volume (OR: 1.001, p < 0.001) were linked to stone-free success. Guy's score (OR: 5.438, p < 0.001), STONE score (OR: 1.741, p < 0.001), and SKS (OR: 3.972, p < 0.001) were strong predictors, but in multivariate analysis, only Guy's score (OR: 3.701, p = 0.010) remained significant. The results of our study demonstrate that the Guy's stone score is the most reliable prognostic tool for predicting stone-free success in pediatric patients undergoing mini-PCNL. Moreover, variables such as stone size and volume exert a substantial influence on the surgical outcomes.
肾结石疾病在儿科人群中相对罕见，尽管其发病率在流行地区稳步上升。微型经皮肾镜取石术（mini-PCNL）被认为是治疗大肾结石最合适的方法，它提供了一种微创且并发症少的选择。本研究评估了STONE、Guy's STONE评分和石肾大小（SKS）评分系统在确定小儿mini-PCNL手术后结石清除率方面的预测准确性。在这项回顾性分析中，研究人员回顾了从2021年1月到2024年6月接受mini-PCNL治疗的79名18岁以下患者的数据。将患者分为残留组和无结石组。使用ROC分析评估模态图在检测残余结石方面的诊断性能，并通过逻辑回归模型确定无结石成功的预测因素。Guy评分（截止值1.5）敏感性79.3%，特异性70%，AUC 0.817。STONE评分（截止5.5）的敏感性为69%，特异性为68%，AUC为0.741。SKS评分（截止值3.5）敏感性为62.1%，特异性为78%，AUC为0.768。Logistic回归发现结石大小(OR: 1.137, p
期刊介绍：
Official Journal of the International Urolithiasis Society
The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field.
Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.
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