Gao, Chuanyu;
Peters, Max;
Kurver, Piet;
Anbarasan, Thineskrishna;
Jayaraajan, Keerthanaa;
Manning, Todd;
Cashman, Sophia;
... BURST Collaborative MIMIC Study Group, .; + view all
(2022)
Nomogram predicting the probability of spontaneous stone passage in patients presenting with acute ureteric colic.
BJU International
, 130
(6)
pp. 823-831.
10.1111/bju.15839.
Preview |
Text
Kasivisvanathan_BJU International - 2022 - Gao - Nomogram predicting the probability of spontaneous stone passage in patients presenting.pdf Download (510kB) | Preview |
Abstract
Objectives: To develop a nomogram that could predict spontaneous stone passage (SSP) in patients presenting with acute ureteric colic who are suitable for conservative management. Patients and Methods: A 2517 patient dataset was utilised from an international multicentre cohort study (MIMIC, A Multi-centre Cohort Study Evaluating the role of Inflammatory Markers In Patients Presenting with Acute Ureteric Colic) of patients presenting with acute ureteric colic across 71 secondary care hospitals in the UK, Ireland, Australia, and New Zealand. Inclusion criteria mandated a non-contrast computed tomography of the kidneys, ureters, and bladder. SSP was defined as the ‘absence of the need for intervention’. The model was developed using logistic regression and backwards selection (to achieve lowest Akaike's information criterion) in a subset from 2009–2015 (n = 1728) and temporally validated on a subset from 2016–2017 (n = 789). Results: Of the 2517 patients, 1874 had SSP (74.5%). The mean (SD) age was 47 (14.7) years and 1892 were male (75.2%). At the end of the modelling process, gender: male (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.64–1.01, P = 0.07), neutrophil count (OR 1.03, 95% CI 1.00–1.06, P = 0.08), hydronephrosis (OR 0.79, 95% CI 0.59–1.05, P = 0.1), hydroureter (OR 1.3, 95% CI 0.97–1.75, P = 0.08), stone size >5–7 mm (OR 0.2, 95% CI 0.16–0.25, P < 0.001), stone size >7 mm (OR 0.11, 95% CI 0.08–0.15, P < 0.001), middle ureter stone position (OR 0.59, 95% CI 0.43–0.81, P = 0.001), upper ureter stone position (OR 0.31, 95% CI 0.25–0.39, P < 0.001), medical expulsive therapy use (OR 1.36, 95% CI 1.1–1.67, P = 0.001), oral nonsteroidal anti-inflammatory drug (NSAID) use (OR 1.3, 95% CI 0.99–1.71, P = 0.06), and rectal NSAID use (OR 1.17, 95% CI 0.9–1.53, P = 0.24) remained. The concordance-statistic (C-statistic) was 0.77 (95% CI 0.75–0.80) and a nomogram was developed based on these. Conclusion: The presented nomogram is available to use as an on-line calculator via www.BURSTurology.com and could allow clinicians and patients to make a more informed decision on pursuing conservative management vs early intervention.
| Type: | Article |
|---|---|
| Title: | Nomogram predicting the probability of spontaneous stone passage in patients presenting with acute ureteric colic |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/bju.15839 |
| Publisher version: | https://doi.org/10.1111/bju.15839 |
| Language: | English |
| Additional information: | © 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
| Keywords: | ureteric colic, predict, spontaneous stone passage, nomogram, multivariable, #KidneyStones, #EndoUrology, #UroStone, #Urology |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10152166 |
Loading...
Loading...Loading...Loading...Archive Staff Only
 |
View Item |
