Predictive Factors for Spontaneous Stone Passage and the Potential Role of Serum C-Reactive Protein in Patients with 4 to 10 mm Distal Ureteral Stones: A Prospective Clinical Study

Özcan, Cihat; Aydoğdu, Özgü; Şenocak, Çağrı; Damar, Erman; Eraslan, Aşır; Öztuna, Derya; Bozkurt, Ömer Faruk

doi:10.1016/j.juro.2015.04.104

Cited by 44 publications

(40 citation statements)

References 21 publications

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“…C-reactive protein could also be used as a predictor of spontaneous passage of ureter stones. Simple uncomplicated ureter stone patients might have low CRP levels [23,24]. The AUROC of the modified STONE and the sensitivity of the high score were significantly higher than those of the STONE score, which needs further multicenter external validation.…”

Section: Discussionmentioning

confidence: 88%

External validation of the STONE score and derivation of the modified STONE score

Kim

et al. 2016

The American Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 88%

External validation of the STONE score and derivation of the modified STONE score

Kim

et al. 2016

The American Journal of Emergency Medicine

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“…Studies that used a multivariate analysis of potential predictors of obstruction noted an association between spontaneous stone passage and degree of hydronephrosis, although this association was not present for other secondary signs of obstruction. [11][12][13] Therefore, few studies have examined the impact of calculus-induced UTO independent from individual secondary CT signs in a manner clinically relevant to urologists and emergency physicians.…”

Section: Discussionmentioning

confidence: 99%

“…14 However, most importantly, we found that obstruction was not an independent criterion for intervention, which is inconsistent with previous studies reporting an association between intervention and degree of hydronephrosis. [11][12][13] Taylor et al, for example, recently reported a + likelihood ratio (LR) of 1.45 for mild hydronephrosis and 3.05 for moderate to severe hydronephrosis. 13 One explanation for this apparent inconsistency is that since hydronephrosis may not be present if obstruction is detected early, it may be an indicator of a more severely decompensated collecting system.…”

Section: Discussionmentioning

confidence: 99%

Is computed tomography-defined obstruction a predictor of urological intervention in emergency department patients presenting with renal colic?

Massaro

Atkinson

Pawsey

et al. 2017

CUAJ

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Introduction: Our objective was to determine whether unilateral calculus-induced ureteric obstruction on computed tomography (CT) was independently associated with the need for urological intervention and 30-day return to the emergency department (ED). Methods:We performed a retrospective cohort study of patients with symptomatic urinary calculi diagnosed by unenhanced helical CT. Stepwise regression analysis was used to determine the predictors of urological intervention and 30-day return to the ED. Potential predictors assessed included: patient demographics, calculus size, calculus location, degree of obstruction, analgesic doses, signs and symptoms of infection, serum creatinine, cumulative intravenous fluid administered, and the prescription of medical expulsive therapy. Results: Of 195 patients, 81 (41.5%) underwent urological intervention. The size of the calculus, its location, and the cumulative opioid dose were all independent predictors for urological intervention. Every 1 mm increase in calculus size increased the likelihood of intervention 2.2 times (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.67-2.85). Proximal stones were 4.7 times more likely to require intervention than distal calculi (OR 0.21; 95% CI 0.09-0.49). Every 10 mg increase in morphine was associated with a 30% increase in the odds of intervention (OR 1.30; 95% CI 1.07-1.58). Degree of obstruction was not associated with the need for urological intervention. Finally, none of the variables were predictors for 30-day return to the ED. Conclusions: Although stone size, proximal location, and severe pain, as indicated by higher opioid doses, were associated with the need for intervention, the degree of obstruction did not influence the management of patients with CT-defined urinary calculi.

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“…Based on the results of univariate and multivariate analysis performed by Özcan et al, the presence of hydronephrosis was reported as a predictive factor for SP. In a univariate analysis conducted by Zorba et al a significant correlation was detected between SP and the presence of hydronephrosis [9,15]. However, in multivariate analysis the presence of hydronephrosis did not appear to be an independent predictive factor.…”

Section: Discussionmentioning

confidence: 89%

“…To summarize, the authors determined that C-reactive protein (CRP) and white blood cell (WBC) values were correlated with SP. They also stated that when deciding on MET for SP these parametres should be taken into consideration [15,16]. Tchey et al investigated the impact of BMI and the history of SP in addition to the parametres of SP time and stone size suitable for SP.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone

Buldu¹

2016

Eu Clin Anal Med

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Anahtar KelimelerÜreter Taşı; Kontrastsız Multidedektör Bilgisayarlı Tomografi; Spontan Pasaj Abstract Aim: The objective of this study is to determine tomographic measurement parametres that are effective on spontaneous passage (SP) of ureteral stones in patients who will undergo unenhanced multidetector computed tomographic examinations (MDCT). Material and Method: The patients who presented with complaints of renal colic to our clinic during 2013-2015 were retrospectively evaluated. The medical files of 813 patients were reviewed and the medical records of 331 cases who had undergone CT were examined. A total of 217 patients whose stone size was less than 10 mm were included in the study. The patients whose stones passed were included in Group 1, and those whose stones did not pass spontaneously were included in Group 2. Data about age and gender of the patients, location, laterality, history of spontaneous stone passage from the ipsilateral side, ureteroscopy, shock wave lithotripsy (SWL), anteroposterior (AP) diameter of the renal pelvis, diameter of the stone as measured on coronal and axial planes, stone volume, and average thickness of the renal parenchyma were evaluated. Parametres effecting passage of the stone were statistically analysed. Results: The mean age of the patients (female, n=152, and male, n=65) was 42.3 years. The patients had upper (n=73) and lower (n=144) ureteral stones. The median diameter of the renal pelvis (17.2 mm), stone diameter on the coronal plane (6.1 mm) and the axial plane (4.6 mm), and thickness of the renal parenchyma (20 mm) were measured. Statistical analysis revealed that the location, volume, diameter of the stone on the coronal and axial planes were influential factors on spontaneous stone passage. In logistic regression analysis, only the location of the stone and its diameter on the coronal plane were found to be independent effective factors on spontaneous stone passage. Discussion: In our study based on data retrieved from MDCT, the location and size of the stone were found to be independent factors affecting spontaneous stone passage. However, a surprising result is that the AP diameter of renal pelvis and renal parenchymal thickness, both of which are factors important for urologists, were not effective on SP.

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Predictive Factors for Spontaneous Stone Passage and the Potential Role of Serum C-Reactive Protein in Patients with 4 to 10 mm Distal Ureteral Stones: A Prospective Clinical Study

Cited by 44 publications

References 21 publications

External validation of the STONE score and derivation of the modified STONE score

External validation of the STONE score and derivation of the modified STONE score

Is computed tomography-defined obstruction a predictor of urological intervention in emergency department patients presenting with renal colic?

Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone

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