loading page

External validation and comparison of current scoring systems in retrograde intrarenal surgery: multi-institutional study with 949 patients
  • +5
  • Ibrahim Halil Bozkurt,
  • Nihat Karakoyunlu,
  • Omer Koras,
  • Serdar Çelik,
  • Ertugrul Sefik,
  • Mehmet Caglar Cakici,
  • Tansu Degirmenci,
  • Muhammed Abdurrahim Imamoglu
Ibrahim Halil Bozkurt
University of Health Sciences Izmir Bozyaka Education and Research Hospital
Author Profile
Nihat Karakoyunlu
Ankara Diskapi Yildirim Beyzat Training and Research Hospital
Author Profile
Omer Koras
Mustafa Kemal University Faculty of Medicine
Author Profile
Serdar Çelik
Izmir Bozyaka Training and Research Hospital
Author Profile
Ertugrul Sefik
University of Health Sciences Izmir Bozyaka Education and Research Hospital
Author Profile
Mehmet Caglar Cakici
Istanbul Medeniyet Universitesi
Author Profile
Tansu Degirmenci
University of Health Sciences Izmir Bozyaka Education and Research Hospital
Author Profile
Muhammed Abdurrahim Imamoglu
HSU, Ankara Dışkapı Training and Research Hospital
Author Profile

Abstract

Objectives: To externally validate and compare Resorlu-Unsal stone score(RUSS), modified Seoul National University Renal Stone Complexity Score(S-ReSC), Ito’s nomogram and R.I.R.S. scoring systems for predicting capabilities of both the stone-free status and complications in a multi-institutional study. Materials and Methods: We performed a retrospective analysis of 949 patients who were underwent flexible ureterorenoscopy (f-URS) and laser lithotripsy for renal stones in two institutions between March-2015 and June-2020. The RUSS, modified S-ReSC, Ito’s nomogram and R.I.R.S. scores were calculated for each patient by same surgeon on imaging methods. Results were compared for their predictive capability of stone-free status and complications. Results: Of 949 patients 603 were male and 346 were female with a mean age of 47.2±14.3 (range 2-84years). Mean stone burden was 102.6±42.2 (48-270mm2). All nomograms predicted stone-free status (AUC were 0.689, 0.657, 0.303 and 0.690, respectively). All four scoring systems predicted complications with AUC values of 0.689, 0.646, 0.286 and 0.664 for RUSS, modified S-ReSC, Ito’s nomogram, R.I.R.S., respectively. Although all scoring systems were able to predict complications only Ito’s nomogram was able to predict Clavien ≥2 complications. Conclusion: All four scoring systems (RUSS, modified S-ReSC, Ito’s nomogram and R.I.R.S.) could predict stone-free status after f-URS, however the AUC values are not satisfactory in our large patient cohort. Although these scoring systems were not developed for predicting post-operative complications, they were associated with complications in our study. However, these four scoring systems have some significant limitations. The ideal scoring system is yet to be developed.

Peer review status:ACCEPTED

01 Dec 2020Submitted to International Journal of Clinical Practice
02 Dec 2020Submission Checks Completed
02 Dec 2020Assigned to Editor
03 Dec 2020Reviewer(s) Assigned
09 Dec 2020Review(s) Completed, Editorial Evaluation Pending
22 Dec 20201st Revision Received
24 Dec 2020Submission Checks Completed
24 Dec 2020Assigned to Editor
24 Dec 2020Reviewer(s) Assigned
27 Dec 2020Review(s) Completed, Editorial Evaluation Pending
18 Feb 2021Editorial Decision: Accept