Sugihara et al developed a nomogram to identify a patient at risk for severe complications after ureteroscopic lithotripsy. These can help to identify patients who may benefit from alternative or more aggressive management. The authors are from multiple universities in Japan.
Patient selection: ureteroscopic lithotripsy
Outcome: severe adverse effects (in-hospital mortality, surgical or medical therapy required to manage complications)
Parameters:
(1) gender
(2) age in years
(3) Charlson Comorbidity Index (CCI)
(4) type of anesthesia
(5) duration of operation in minutes
(6) hospital volume for ureteroscopic lithotripsy per year
(7) type of admission
|
Parameter |
Finding |
Points |
|
gender |
male |
0 |
|
|
female |
24.2 |
|
age in years |
<= 59 years |
0 |
|
|
50 to 69 years |
19.2 |
|
|
70 to 79 years |
20.9 |
|
|
>= 80 years |
51.3 |
|
CCI |
0 |
0 |
|
|
1 |
20.3 |
|
|
2 |
39.8 |
|
|
>= 3 |
56.3 |
|
type of anesthesia |
spinal or epidural |
0 |
|
|
general |
22.7 |
|
operation time |
< 60 minutes |
0 |
|
|
60 to 89 minutes |
25.8 |
|
|
90 to 119 minutes |
31.5 |
|
|
120 to 149 minutes |
55.5 |
|
|
150 to 179 minutes |
60.3 |
|
|
180 to 209 minutes |
73.4 |
|
|
>= 210 minutes |
100 |
|
hospital volume |
<= 15 |
31.3 |
|
|
16 to 38 |
14.8 |
|
|
>= 39 |
0 |
|
type of admission |
elective |
0 |
|
|
emergency without ambulance transfer |
39.8 |
|
|
emergency with ambulance transfer |
70.7 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: > 300
• The higher the score the more likely there will be a severe adverse event.
|
Score |
Probability of a Severe Adverse Event |
|
< 43 |
< 1% |
|
43 to 232 |
(0.000328 * ((points)^2)) - (0.02869 * (points)) + 1.708 |
|
232 to 264 |
(0.1787 * (points)) - 27.38 |
|
> 264 |
> 20% |
Specialty: Nephrology, Clinical Laboratory
ICD-10: ,
