Comparing different kidney stone scoring systems for predicting percutaneous nephrolithotomy outcomes: A multicenter...

Area of Science:

• Urology
• Nephrolithiasis Research
• Surgical Outcomes Analysis

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
• Accurate prediction of postoperative outcomes is crucial for patient management and surgical planning.
• Several scoring systems exist to predict PCNL outcomes, but their comparative performance needs evaluation.

Purpose of the Study:

• To compare the predictive performance of five scoring systems (S.T.O.N.E., Guy's, CROES, S-RESC, and SKS) for stone-free rate (SFR) and complications after PCNL.
• To identify the most accurate scoring system for predicting SFR and complications in adult PCNL patients.

Main Methods:

• Retrospective analysis of 349 adult patients undergoing PCNL.
• Application of SKS, S.T.O.N.E., S-RESC, CROES, and Guy's scoring systems to predict outcomes.
• Univariate and multivariate analyses, ROC curves, and AUC comparisons to assess predictive value for SFR and complications.

Main Results:

• The Seoul National University Renal Stone Complexity (S-RESC) scoring system demonstrated the highest discriminative performance for predicting stone-free status (AUC 0.869).
• All evaluated scoring systems showed significant correlation with stone-free status.
• None of the scoring systems effectively predicted postoperative complications.

Conclusions:

• The S-RESC scoring system is the most accurate among the evaluated methods for predicting stone-free status after PCNL.
• S-RESC is easy to implement and highly reproducible, making it a valuable tool for predicting stone clearance.
• Current scoring systems are inadequate for predicting postoperative complications following PCNL.