Can the stone scoring systems be used to predict infective complications of retrograde intrarenal surgery?

Abstract

Aim: In this study, we aimed to evaluate the association between infective complications after retrograde intrarenal surgery (RIRS) and RIRS scoring systems includes the Resorlu-Unsal Stone Score (RUSS), Modified Seoul National University renal stone complexity score (modified S-ReCS) and R.I.R.S score. Methods: Patients with renal calculi detected on imaging, who underwent RIRS in the urology clinic of a tertiary hospital between January 2013 and May 2020 were included in the study. A total of 581 patients who underwent RIRS for the kidney stones detected with imaging methods were included in the study. The RUSS and modified S-ReCS and R.I.R.S. scores of the patients were determined. Results: Infective complications were detected in 47 (8.1%) patients who underwent RIRS. There were fever in 27 (4.6%), urinary infection in 15 (2.5%), sepsis in 2 (0.3%) and septic shock in 3 (0.5%) patients. In multivariate logistic regression analysis, age (OR: 1.8; 95% CI: 1-3.4; p:0.049), surgical duration of >60 minutes (OR: 1.9; 95% Cl: 1.1–3.5; p:0.027) RIRS score (OR: 8.9; 95% CI: 1.9-42.4; p:0.006) have been shown to be independent risk factors for the development of infective complications. A ROC curve analysis showed that the R.I.R.S scoring system can be used as a marker to predict infective complications. (Area under the curve (AUC):0.619, CI: 0.55–0.69; p:0.007) The cut-off point for the R.I.R.S scoring system was found to be 5.5 points using Youden’s test. Conclusion: In our study, we showed that the R.I.R.S scoring system can be used to predict infective complications in RIRS.