PD14-04 DEVELOPMENT OF A RISK CALCULATOR TO PREDICT SPONTANEOUS STONE PASSAGE IN PATIENTS WITH ACUTE URETERIC COLIC

Abstract

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (PD14)1 Apr 2020PD14-04 DEVELOPMENT OF A RISK CALCULATOR TO PREDICT SPONTANEOUS STONE PASSAGE IN PATIENTS WITH ACUTE URETERIC COLIC Chuanyu Gao*, Max Peters, Keerthanaa Jayaraajan, Todd Manning, Sophia Cashman, Arjun Nambiar, Marcus Cumberbatch, Ben Lamb, Anthony Peacock, Marieke J. Van Son, Peter S. N. van Rossum, Robert Pickard, Paul Erotocritou, Daron Smith, Taimur Shah, and Veeru Kasivisvanathan Chuanyu Gao*Chuanyu Gao* More articles by this author , Max PetersMax Peters More articles by this author , Keerthanaa JayaraajanKeerthanaa Jayaraajan More articles by this author , Todd ManningTodd Manning More articles by this author , Sophia CashmanSophia Cashman More articles by this author , Arjun NambiarArjun Nambiar More articles by this author , Marcus CumberbatchMarcus Cumberbatch More articles by this author , Ben LambBen Lamb More articles by this author , Anthony PeacockAnthony Peacock More articles by this author , Marieke J. Van SonMarieke J. Van Son More articles by this author , Peter S. N. van RossumPeter S. N. van Rossum More articles by this author , Robert PickardRobert Pickard More articles by this author , Paul ErotocritouPaul Erotocritou More articles by this author , Daron SmithDaron Smith More articles by this author , Taimur ShahTaimur Shah More articles by this author , and Veeru KasivisvanathanVeeru Kasivisvanathan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000848.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal colic is a common urological problem with a lifetime incidence of approximately 8-19% in males and 3-5% in females. The MIMIC Study was a 4171 patient cohort study assessing clinical outcomes in patients admitted to hospital with renal colic and a CT-confirmed obstructing ureteric calculus. One of the aims of the study was to establish what the most important predictors of spontaneous stone passage (SSP) were. In this report, we present a risk calculator developed from the MIMIC study data that can be used by clinicians when a patient is admitted with ureteric colic. METHODS: Using the MIMIC Study results, the influence of hydronephrosis, hydroureter, perinephric stranding, temperature, stone size and stone position on computed tomography on SSP were assessed. Multiple imputation was used for missing data. Logistic regression was used to obtain the set of variables with the highest predictive ability for SSP and the corrected β-coefficients after internal validation was used to create a nomogram. The nomogram was externally validated in a subset of patients from 2016-2017. RESULTS: An online risk calculator was created which informs clinicians and patients of the chances of SSP based on patient’s presenting features. In total, 2518 patients discharged with initial conservative management were included in the modelling process, of which 1874 had SSP (74.4%). Mean age was 47 (±14.7) and 1892 were male (75.3%). The most important predictive factors for spontaneous stone passage were stone size (p<0.0001), stone position (p<0.0001) and neutrophil count (p = 0.06). The model was developed and internally validated in a subset of patients from 2009-2015 (n=1728) with an apparent C-statistic of the uncorrected model of 0.77 indicating good discrimination and externally validated on a subset of patients from 2016 and 2017 (n=789) confirming that the model was sensitive to temporal trends. A Nomogram representing the findings is presented in Figure 1 and can determine a probability of spontaneous stone passage ranging from 20% to 95% CONCLUSIONS: In this report, we present a risk calculator developed from the MIMIC study that can aid clinical decision-making by determining an individual patient’s risk of spontaneous stone passage when admitted with ureteric colic. Source of Funding: Prostate Cancer UK (PCUK) St Peters Trust for Clinical Research Astellis Ferring Galil Medical Doctoral Research Fellowship from the National Institute for Health Research European Association of Urology American Urology Association © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e273-e273 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chuanyu Gao* More articles by this author Max Peters More articles by this author Keerthanaa Jayaraajan More articles by this author Todd Manning More articles by this author Sophia Cashman More articles by this author Arjun Nambiar More articles by this author Marcus Cumberbatch More articles by this author Ben Lamb More articles by this author Anthony Peacock More articles by this author Marieke J. Van Son More articles by this author Peter S. N. van Rossum More articles by this author Robert Pickard More articles by this author Paul Erotocritou More articles by this author Daron Smith More articles by this author Taimur Shah More articles by this author Veeru Kasivisvanathan More articles by this author Expand All Advertisement PDF downloadLoading ...