Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a sys
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RESEARCH ARTICLE
Open Access
Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis Kehua Jiang1, Fa Sun1*, Jianguo Zhu1, Guangheng Luo1, Peng Zhang1, Yong Ban1, Gang Shan1 and Changxiang Liu2
Abstract Background: Clinical studies assessing the feasibility and accuracy of three stone scoring systems’s (SSSs: Guy’s stone score, CROES nomogram and S.T.O.N.E nephrolithometry scoring system) have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and accuracy of three SSSs. Methods: A systematic search of Embase, Pubmed, Medline, and the Cochrane Library was conducted to identify studies that compared three SSSs up to Mar 2018. Patients were categorized according to stone free (SF) and no-stone free (NSF), Outcomes of interest included perioperative variables, stone-free rate (SFR), and complications. Results: Ten studies estimating three SSSs were included for meta-analysis. The results showed that SF patients had a significantly lower proportion of male (OR = 1.48, P = 0.0007), lower stone burden (WMD = -504.28, P < 0.0001), fewer No of involved calyces (OR = -1.23, P = 0.0007) and lower proportion of staghorn stone (OR = 0.33, P < 0.0001). Moreover, SF patients had significantly lower score of Guy score (WMD = -0.64, P < 0.0001), but, S.T.O.N.E. score (WMD = -1.23, P < 0.0001) and a higher score of CROES nomogram (WMD = 29.48, P = 0.003). However, the comparison of area under curves (AUC) of predicting SFR indicated that there was no remarkable difference between three SSSs. Nonetheless, Guy score was the only stone scoring system that predicted complications after PCNL (WMD = -0.29, 95% CI: − 0.57 to − 0.02, P = 0.03). Conclusions: Our meta-analysis indicated that the three SSSs were equally, feasible and accurate for predicting SFR after PCNL. However, Guy score was the only stone scoring system that predicted complications after PCNL. Keywords: Guy’s score, S.T.O.N.E. score, CROES nomogram, Stone free rate, Meta-analysis
Background The recommended treatment option for renal calculi and staghorn calculi is percutaneous nephrolithotomy (PCNL) according to the guidelines of the European Association of Urology (EAU) [1]. PCNL has increasingly been used over the past few decades and may continue in the future [2, 3]. However, PCNL outcomes among the authors are different, because of the vast * Correspondence: [email protected] 1 Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China Full list of author information is available at the end of the article
heterogeneity in the methods for clinical and academic characterization of nephrolithiasis besides the evaluation of surgical outcomes. So assessing the preoperative factors that affect SFR and complications is critical. The Guy’s stone score, the Clinical Research Office of the Endourological Society(CROES) nomogram and the S.T.O.N.E.(stone size, tract length, obst
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