Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis

Abstract

Background Clinical studies assessing the feasibility and accuracy of three stone scoring systems’s (SSSs: Guy’s stone score, CROES nomogram and S.T.O.N.E nephrolithometry scoring system) have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and accuracy of three SSSs. Methods A systematic search of Embase, Pubmed, Medline, and the Cochrane Library was conducted to identify studies that compared three SSSs up to Mar 2018. Patients were categorized according to stone free (SF) and no-stone free (NSF), Outcomes of interest included perioperative variables, stone-free rate (SFR), and complications. Results Ten studies estimating three SSSs were included for meta-analysis. The results showed that SF patients had a significantly lower proportion of male (OR = 1.48, P = 0.0007), lower stone burden (WMD = -504.28, P < 0.0001), fewer No of involved calyces (OR = -1.23, P = 0.0007) and lower proportion of staghorn stone (OR = 0.33, P < 0.0001). Moreover, SF patients had significantly lower score of Guy score (WMD = -0.64, P < 0.0001), but, S.T.O.N.E. score (WMD = -1.23, P < 0.0001) and a higher score of CROES nomogram (WMD = 29.48, P = 0.003). However, the comparison of area under curves (AUC) of predicting SFR indicated that there was no remarkable difference between three SSSs. Nonetheless, Guy score was the only stone scoring system that predicted complications after PCNL (WMD = -0.29, 95% CI: − 0.57 to − 0.02, P = 0.03). Conclusions Our meta-analysis indicated that the three SSSs were equally, feasible and accurate for predicting SFR after PCNL. However, Guy score was the only stone scoring system that predicted complications after PCNL.

Novel prediction scoring system for simple assessment of stone‐free status after flexible ureteroscopy lithotripsy: T.O.HO. score

“…6,7 Guy's stone score, 8 the CROES nomogram, 9 and the STONE nephrolithometry scoring system 10 were each developed as an assessment tool to predict the stone-free rate and complications after PCNL, and a recent meta-analysis showed that these scoring systems can be useful for predicting outcomes of PCNL. 11 As for URL, two scoring systems and one nomogram are available, and among them, only the STONE score can be used for both renal and ureteral stones. [12][13][14] An internal validation study of the STONE score carried out by those authors showed that the stone-free predictive accuracy was satisfactory, with an AUC of 0.764.…”

Guy’s stone Scoring in Predicting Post operative Residual Stones

“…CT plays a very important role in preoperative assessment of stone's characteristics and renal anatomy. Various scoring systems like Guy's scoring, CROES nomogram and S.T.O.N.E., are based on findings of preoperative CT. 9,10 Aims of the study was to determine the frequency of postoperative residual stone based on pre-procedural Guy's scoring system.…”

External validation of the T.O.HO. score and derivation of the modified T.O.HO. score for predicting stone-free status after flexible ureteroscopy in ureteral and renal stones

“…[6][7][8][9] It has been proven that stone-free status (SFS) and development of complications can be effectively predicted with scoring systems, especially in PCNL. 10 In the literature, several scoring systems, including Resorlu-Unsal 11 , STONE 12 , S-ReSC 13 , and R.I.R.S. 14 and one nomogram 15 have been defined to predict the success of fURS.…”