Analysis of multiple factors to predict the stone free rate of flexible ureteroscopic lithotripsy and the clinical significance of stone-free index model
10.3760/cma.j.issn.1000-6702.2015.06.006
- VernacularTitle:软性输尿管镜碎石术清石率的多因素分析及清石指数模型建立的临床意义
- Author:
Weiwen YU
;
Xiang HE
;
Jiong YAO
;
Mi ZHOU
;
Shuai WANG
;
Guodong LIAO
;
Yuelong ZHANG
;
Baiye JIN
;
Dahong ZHANG
- Publication Type:Journal Article
- Keywords:
Flexible ureteroscope;
Lithotripsy;
Stone free rate;
Stone free index
- From:
Chinese Journal of Urology
2015;(6):423-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the related factors that influence the stone free rate ( SFR) in flexible ureteroscopic lithotripsy ( FURL ) and develop a stone free index ( SFI ) model to estimate and predict the outcome of FURL.Methods A total of 393 patients receiving FURL were included in this study from May 2013 to August 2014.All patients′and calculous characteristics were recorded.It was evaluated the correlation of one-stage SFR with body mass index, the degree of hydronephrosis, the sterile urine, the renal insufficiency, the stone location, the stone number, the cumulative stone diameter ( CSD) , the stone density, the average of CT values, the minimum angle of pelvis ureter long axis with lamp long axis, the average length of stone located calyx-neck, and the minimum ratio of stone located calyx-neck′width with calyx′width.Multivariate regression analysis was used to analyze the relationship between preoperative characteristics and the SFR.Results The one-stage postoperative SFR in our study was 92.4% ( 363/393).We found that the staghorn stone, bacteriuria, CSD, average of CT values, the average length of stone located calyx-neck, the minimum ratio of stone located calyx-neck′width with calyx′width were significantly correlated with the postoperative SFR ( P <0.05 ) .We used logistic regression analysis to determine statistical significant variables and to create predictable mathematical model.The SFI system was consist of four stone characteristics, including the staghorn stone, the cumulative stone diameter, the average length of stone located calyx-neck, and the minimum ratio of stone located calyx-neck′width with calyx′width.The SFI had a high ROC curve (AUC=0.867) for predicting the one-stage postoperative stone free outcome.SFI score >7.5 meant a relatively high SFR ( SFR>85%) of FURL.Conclusions A SFI model using preclinical data was developed to predict the postoperative outcome of FURL, as well as the one-stage SFR.This model needs further prospective studies in the future.
