Dataset Information

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S₃HoCKwave score.

ABSTRACT: Purpose: To develop and validate a new clinical prediction model that accurately predicts the failure of shockwave lithotripsy (SWL) using information obtained from non-contrast-enhanced computed tomography (NCCT).

Methods: This multicentre retrospective cohort study consecutively enrolled patients diagnosed with upper urinary tract calculi by NCCT at five hospitals in Japan from January 1, 2006 to December 31, 2016. Among the candidate predictors, we selected the six most significant predictors a priori. The main outcome was SWL failure after three sessions. Model calibration was evaluated by the calibration slope and the Hosmer-Lemeshow test. Discrimination was evaluated by the receiver-operating characteristic curves and the area under the curve (AUC). A multivariable logistic regression analysis was performed; based on the estimated ? coefficients, predictive scores were generated.

Results: Of 2695 patients, 2271 were included. Patients were divided into the development cohort (1666 patients) and validation cohort (605 patients) according to geographical factors. We developed a clinical prediction model with scores ranging from 0 to 49 points. We named the prediction model the S₃HoCKwave score based on the initials of the predictors (sex, skin-to-stone distance, size, Hounsfield units, colic, and kidney or ureter). As a result of internal validation, the optimism-corrected AUC was 0.72. In the validation cohort, the Hosmer-Lemeshow test did not show statistical significance (P?=?0.33), and the AUC was 0.71 (95% confidence interval 0.65-0.76).

Conclusions: The S₃HoCKwave score is easy to understand, has a relatively high predictive value, and allows clinicians to make appropriate treatment selections.

SUBMITTER: Yoshioka T

PROVIDER: S-EPMC7716893 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S<sub>3</sub>HoCKwave score.

Yoshioka Takashi T Ikenoue Tatsuyoshi T Hashimoto Hideaki H Otsuki Hideo H Oeda Tadashi T Ishito Noritaka N Watanabe Ryuta R Saika Takashi T Araki Motoo M Fukuhara Shunichi S Yamamoto Yosuke Y

World journal of urology 20200222 12

<h4>Purpose</h4>To develop and validate a new clinical prediction model that accurately predicts the failure of shockwave lithotripsy (SWL) using information obtained from non-contrast-enhanced computed tomography (NCCT).<h4>Methods</h4>This multicentre retrospective cohort study consecutively enrolled patients diagnosed with upper urinary tract calculi by NCCT at five hospitals in Japan from January 1, 2006 to December 31, 2016. Among the candidate predictors, we selected the six most significa ...[more]

PMID: 32088747

Similar Datasets

Project description:BackgroundMicro computed tomography (micro CT) has been shown to provide exceptionally high quality imaging of the fine structural detail within urinary calculi. We tested the idea that micro CT might also be used to identify the mineral composition of urinary stones non-destructively.MethodsMicro CT x-ray attenuation values were measured for mineral that was positively identified by infrared microspectroscopy (FT-IR). To do this, human urinary stones were sectioned with a diamond wire saw. The cut surface was explored by FT-IR and regions of pure mineral were evaluated by micro CT to correlate x-ray attenuation values with mineral content. Additionally, intact stones were imaged with micro CT to visualize internal morphology and map the distribution of specific mineral components in 3-D.ResultsMicro CT images taken just beneath the cut surface of urinary stones showed excellent resolution of structural detail that could be correlated with structure visible in the optical image mode of FT-IR. Regions of pure mineral were not difficult to find by FT-IR for most stones and such regions could be localized on micro CT images of the cut surface. This was not true, however, for two brushite stones tested; in these, brushite was closely intermixed with calcium oxalate. Micro CT x-ray attenuation values were collected for six minerals that could be found in regions that appeared to be pure, including uric acid (3515 - 4995 micro CT attenuation units, AU), struvite (7242 - 7969 AU), cystine (8619 - 9921 AU), calcium oxalate dihydrate (13815 - 15797 AU), calcium oxalate monohydrate (16297 - 18449 AU), and hydroxyapatite (21144 - 23121 AU). These AU values did not overlap. Analysis of intact stones showed excellent resolution of structural detail and could discriminate multiple mineral types within heterogeneous stones.ConclusionsMicro CT gives excellent structural detail of urinary stones, and these results demonstrate the feasibility of identifying and localizing most of the common mineral types found in urinary calculi using laboratory CT.

Project description:BackgroundLithotripsy with holmium:yttrium-aluminum-garnet (Ho:YAG) laser is the current gold standard for treating stones of the upper urinary tract (UUT). The recently introduced thulium fiber laser (TFL) has the potential to be more efficient and as safe as Ho:YAG.ObjectiveTo compare the performance and complications between Ho:YAG and TFL for UUT lithotripsy.Design setting and participantsThis was a prospective single-center study of 182 patients treated between February 2021 and February 2022. In a consecutive approach, laser lithotripsy was performed via ureteroscopy with Ho:YAG for 5 mo, and then with TFL for 5 mo.Outcome measurements and statistical analysisOur primary outcome was stone-free (SF) status at 3 mo after ureteroscopy with Ho:YAG versus TFL lithotripsy. Secondary outcomes were complication rates and results regarding the cumulative stone size. Patients were followed at 3 mo with abdominal imaging (ultrasound or computed tomography).Results and limitationsThe study cohort comprised 76 patients treated with Ho:YAG laser and 100 patients treated with TFL. Cumulative stone size was significantly higher in the TFL than in the Ho:YAG group (20.4 vs 14.8 mm; p = 0.01). SF status was similar in both groups (68.4% vs 72%; p = 0.06). Complication rates were comparable. In subgroup analysis, the SF rate was significantly higher (81.6% vs 62.5%; p = 0.04) and the operative time was shorter for stones measuring 1-2 cm, whereas the results were similar for stones <1 cm and >2 cm. The lack of randomization and single-center design are the main limitations of the study.ConclusionsTFL and Ho:YAG lithotripsy are comparable in terms of the SF rate and safety for the treatment of UUT lithiasis. According to our study, for a cumulative stone size of 1-2 cm, TFL is more effective than Ho:YAG.Patient summaryWe compared the efficiency and safety of two laser types for the treatment of stones in the upper urinary tract. We found that stone-free status at 3 months did not significantly differ between the holmium and thulium lasers.

Dataset Information

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S₃HoCKwave score.

Publications

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S<sub>3</sub>HoCKwave score.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S3HoCKwave score.

Publications

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S<sub>3</sub>HoCKwave score.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Development and validation of a prediction model for failed shockwave lithotripsy of upper urinary tract calculi using computed tomography information: the S₃HoCKwave score.