INTRODUCTION AND OBJECTIVE: Few tools are available to predict ureterolithotripsy outcomes in patients with ureteral stones. Aim of our study was to develop a nomogram predicting the probability of stone free rate in patients undergoing semirigid ureterolithotripsy (ULT) for ureteral stones. METHODS: From January 2014 onwards, 359 patients undergoing semirigid Ho: YAG laser ureterolithotripsy for ureteral stones were prospectively enrolled in two centers. Patients were preoperatively evaluated with accurate clinical history, urinalysis and renal function. Non-contrast CT was used to define number, location and length of the stones and eventually the presence of hydronephrosis. Residual stones were evaluated at 3 months after surgery with non-contrast CT. A nomogram was generated based on the logistic regression model used to predict ULT success. Predictive accuracy was quantified using the concordance index (CI). RESULTS: Median age was 54 years (IQR:44/65), median BMI 23.4 kg/m2 (IQR:22/28), median length of the stone was 8 mm (IQR:6/11). 272/359 (71%) patients presented hydronephrosis, pyuria on urinalysis was detected in 46/59 (2.1%). 232/359 (65%) patients were stone free at 3 months. On multivariate analysis single stone (OR:1.93, 95%CI:1.05-3.53, p=0.034), stone size (OR:0.92, 95%CI:0.87-0.97, p=0.005), distal position (OR:2.12, 95%CI:1.29-3.48, p=0.003) and the abscence of hydronephrosis (OR:2.02, 95%CI:1.08-3.78, p=0.029) were predictors of success. Figure 1 graphically shows the multivariable effect of each variable on the probability of success in the form of a nomogram. The c-index for the model was 0.70. CONCLUSIONS: We developed a clinical nomogram to predict stone free rate in patients undergoing ureterolithotripsy. The implementation of our nomogram could better identify patients at risk of failure and therefore needing multiple treatments. External validation is warranted before its clinical implementation.

Development of a nomogram predicting the probability of stone free rate in patients with ureteral stones eligible for laser ureterolitothripsy / De Nunzio, C; Lombardo, R; Russo, G; Albano, A; Bellangino, M; Baldassarri, V; Sica, A; Lopez, J; Luque, P; Ribal, Mj; Alcaraz, A; Tubaro, A. - In: THE JOURNAL OF UROLOGY. - ISSN 0022-5347. - 203:Suppl 4(2020), pp. E962-E962. (Intervento presentato al convegno Annual Meeting of the American-Urological-Association (AUA) tenutosi a Washington).

Development of a nomogram predicting the probability of stone free rate in patients with ureteral stones eligible for laser ureterolitothripsy

De Nunzio, C
;
Lombardo, R;Bellangino, M;Baldassarri, V;Alcaraz, A;Tubaro, A
2020

Abstract

INTRODUCTION AND OBJECTIVE: Few tools are available to predict ureterolithotripsy outcomes in patients with ureteral stones. Aim of our study was to develop a nomogram predicting the probability of stone free rate in patients undergoing semirigid ureterolithotripsy (ULT) for ureteral stones. METHODS: From January 2014 onwards, 359 patients undergoing semirigid Ho: YAG laser ureterolithotripsy for ureteral stones were prospectively enrolled in two centers. Patients were preoperatively evaluated with accurate clinical history, urinalysis and renal function. Non-contrast CT was used to define number, location and length of the stones and eventually the presence of hydronephrosis. Residual stones were evaluated at 3 months after surgery with non-contrast CT. A nomogram was generated based on the logistic regression model used to predict ULT success. Predictive accuracy was quantified using the concordance index (CI). RESULTS: Median age was 54 years (IQR:44/65), median BMI 23.4 kg/m2 (IQR:22/28), median length of the stone was 8 mm (IQR:6/11). 272/359 (71%) patients presented hydronephrosis, pyuria on urinalysis was detected in 46/59 (2.1%). 232/359 (65%) patients were stone free at 3 months. On multivariate analysis single stone (OR:1.93, 95%CI:1.05-3.53, p=0.034), stone size (OR:0.92, 95%CI:0.87-0.97, p=0.005), distal position (OR:2.12, 95%CI:1.29-3.48, p=0.003) and the abscence of hydronephrosis (OR:2.02, 95%CI:1.08-3.78, p=0.029) were predictors of success. Figure 1 graphically shows the multivariable effect of each variable on the probability of success in the form of a nomogram. The c-index for the model was 0.70. CONCLUSIONS: We developed a clinical nomogram to predict stone free rate in patients undergoing ureterolithotripsy. The implementation of our nomogram could better identify patients at risk of failure and therefore needing multiple treatments. External validation is warranted before its clinical implementation.
2020
Annual Meeting of the American-Urological-Association (AUA)
nomogram
04 Pubblicazione in atti di convegno::04c Atto di convegno in rivista
Development of a nomogram predicting the probability of stone free rate in patients with ureteral stones eligible for laser ureterolitothripsy / De Nunzio, C; Lombardo, R; Russo, G; Albano, A; Bellangino, M; Baldassarri, V; Sica, A; Lopez, J; Luque, P; Ribal, Mj; Alcaraz, A; Tubaro, A. - In: THE JOURNAL OF UROLOGY. - ISSN 0022-5347. - 203:Suppl 4(2020), pp. E962-E962. (Intervento presentato al convegno Annual Meeting of the American-Urological-Association (AUA) tenutosi a Washington).
File allegati a questo prodotto
File Dimensione Formato  
DeNunzio_Development_2020.pdf

solo gestori archivio

Note: Meeting Abstract: MP63-19
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 100.81 kB
Formato Adobe PDF
100.81 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1452619
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 0
social impact