Can CT-Based Stone Impaction Markers Augment the Predictive Ability of Spontaneous Stone Passage?

Kachroo, Naveen; Jain, Rajat; Maskal, Sarah; Alshara, Luay; Armanyous, Sherif; Milk, Jason; Kahn, Leonard B.; Monga, Manoj; Sivalingam, Sri

doi:10.1089/end.2020.0645

Cited by 15 publications

(16 citation statements)

References 24 publications

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“…Limited studies indicate criteria for the identification of those patients. 22 There is no available tool or score for the identification of patients with stones unlikely to pass spontaneously. However, a cardiovascular risk assessment score (Framingham score) was used recently to predict SSP, and it was shown that a higher score is associated with EI.…”

Section: Discussionmentioning

confidence: 99%

“…Stone impaction markers, radiological signs of potential infection, and degree of obstruction have been a trending question in the literature since the adoption of NCCT as the modality of choice to evaluate ureteral calculi. 16 , 22 Several published articles studied the value of such signs in the prospect of diagnosis in complicated ureteral calculi, duration of stone impaction, and the presence of underlying ureteral abnormalities such as strictures and polyps. 30 , 31 We found that the extrarenal pelvis, AP diameter of the renal pelvis, and UWT are significantly associated with EI.…”

Section: Discussionmentioning

confidence: 99%

“…This is supported by the available evidence, which showed that UWT could serve as a potential predictive factor for SSP if UWT is less than 2.3 mm and may help physicians identify patients who require EI, especially if UWT is more than 2.71 mm. 17 , 18 , 22 Lastly, there is controversy in the literature regarding the role of ureteral diameter and the relation between ureteral and stone diameter in the prospect of SSP. 23 , 32 This study supports the idea that the increase in UWT and the dilatation of the urinary tract above the level of obstruction decrease the chance of SSP and promote EI.…”

Section: Discussionmentioning

confidence: 99%

“…30,31 We found that the extrarenal pelvis, AP diameter of the renal pelvis, and UWT are significantly associated with EI. A higher degree of renal pelvis distention represented by an AP diameter of 18 mm [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] is significantly associated with EI. The significance of the dilatation of the renal pelvis and the degree of hydronephrosis has previously been studied.…”

Section: Dovepressmentioning

confidence: 99%

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Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Abushamma¹,

Ktaifan²,

Abdallah³

et al. 2021

IJGM

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Purpose Acute ureteric colic (AUC) is generally one of the most common reasons for emergency department attendance. Expectant management is recommended in non-complicated ureteral calculi. However, data regarding the optimal duration of observation or indications of early intervention (EI) are not well understood. This article describes the clinical and radiological factors that promote EI in AUC. Patients and Methods This was an observational and retrospective cohort study. Patients with AUC diagnosed based on non-contrast computerized tomography (NCCT) between 2019 and 2020 were enrolled in the study. These patients were classified into two main categories: spontaneous passage of stone (SSP) and EI. In addition, a comparative analysis was performed to identify clinical and radiological variables that promote EI. Results One-hundred and sixty-one patients were included. High WBCs are associated with a significant increase in EI. Forty-three percent (n=37) of patients with serum WBCs higher than 10 had an EI, while 23% had SSP (n=17; p <0.001). High CRP level is also significantly associated with EI (n=36; 86%; p <0.001). Upper and middle ureteral calculi are statistically associated with EI (n=54; 62%) in comparison to the SSP cohort (n=22; 30%; p <0.001). EI is also linked to the maximal length of ureteric calculi (MCL) of 9 mm (6–13mm), and HU density of stone of 700 (430–990) H.U ( p <0.001). Ureteric stone volume of 0.2 (0.06–0.3) cm 3 is significantly associated with EI ( p <0.001). Ureteral wall thickness of 3 (2–3 mm), the presence of extrarenal pelvis (n=20; 23%), and AP diameter of renal pelvis 18 (13–28 mm) are all significantly associated with a higher rate of EI ( p <0.001). Multiple binary logistic regression analysis showed that MCL is the strongest predictor of EI. Conclusion MCL is an independent and robust predictor of EI in AUC. Biochemical variables and radiological characteristics can also act as an adjunct to promote EI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

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Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Abushamma¹,

Ktaifan²,

Abdallah³

et al. 2021

IJGM

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“…The advantages and disadvantages of conservative management and early intervention make it difficult to decide whether to choose conservative management or active stone removal. In addition to the size and location of the stone, previous papers have assessed several other parameters [7][8][9][10][11] to predict SSP; however, it remains unclear which patients are appropriate for conservative management. In recent years, inflammatory parameters, including white blood cell (WBC) and neutrophil counts [1], neutrophil-to-lymphocyte ratio (NLR) [12,13], and platelet-to-lymphocyte ratio (PLR) [13] have been assessed to predict SSP.…”

Section: Introductionmentioning

confidence: 99%

What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

Senel

Aykanat²,

Asfuroglu

et al. 2022

Aktuelle Urol

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Purpose: To investigate the role of inflammatory markers in predicting the spontaneous passage of ureteral stones. Methods: We retrospectively reviewed 279 patients with ureteral stones sized 4–10 mm that were managed conservatively. The patients were divided into two groups: Group 1 consisted of 137 patients who passed the stone spontaneously; Group 2 comprised 142 patients without spontaneous stone passage. The groups were compared using the Mann-Whitney U and chi-square tests. In addition, univariate and multivariate analyses were performed to identify the significance of the parameters. Results: The mean age of the patients was 41.2 years. The patients in Group 1 had a significantly lower mean stone size, white blood cell count and neutrophil count. In addition, stone location, presence of hydronephrosis and history of urolithiasis were significantly different between the groups. Neutrophil percentage, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were insignificantly lower in Group 1. In a multivariate analysis, stone size, distal location and hydronephrosis status significantly predicted the spontaneous stone passage. However, inflammatory markers including white blood cell count, neutrophil count and neutrophil-to-lymphocyte ratio could not determine the likelihood of spontaneous stone passage. Conclusion: Our results suggest that inflammatory markers are no meaningful parameters for the prediction of spontaneous stone passage.

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Predicting narrow ureters before ureteroscopic lithotripsy with a neural network: a retrospective bicenter study

Wang

et al. 2022

Urolithiasis

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Can CT-Based Stone Impaction Markers Augment the Predictive Ability of Spontaneous Stone Passage?

Cited by 15 publications

References 24 publications

Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

Clinical and Radiological Predictors of Early Intervention in Acute Ureteral Colic

What is the role of inflammatory markers in predicting spontaneous ureteral stone passage?

Predicting narrow ureters before ureteroscopic lithotripsy with a neural network: a retrospective bicenter study

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