Gu et al reported the HLPES score for evaluating a patient with nephrolithiasis. This can predict stone-free status after flexible ureteroscopy. The authors are from Chongqing Medical University in China.
The HLPES is based on the SOLVE score.
Patient selection: kidney stone, status post flexible ureteroscopy
Stone-free status was defined as one of the following on imaging 1 month after procedure:
(1) no residual stone
(2) residual stone < 4 mm
Parameters:
(1) height (H) of the pelvic calyx in mm (vertical distance between the horizontal line of the lowest point of the lower calyces where the calculus is located and the highest point of the lower lip)
(2) length of the calyces funnel (L) in mm (distance between the farthest point of the lower calyx where the calculus is located and the middle point of the lower lip of the renal pelvis)
(3) pelvis volume (P) in cubic mm
(4) essence of the stone (E) in Hounsfield Units (HU) in CT images
(5) stone surface area (S) in square mm (units in paper cubic mm)
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Parameter
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Finding
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Points
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height
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<= 21 mm
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1
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> 21 mm
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2
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length
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<= 25 mm
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1
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> 25 mm
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2
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pelvis
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<= 2,214 cubic mm
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1
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> 2,214 cubic mm
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2
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stone essence
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<= 1,425 HU
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1
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> 1,425 HU
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2
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stone surface area
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<= 969 cubic mm
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1
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> 969 cubic mm
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2
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total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 5 (paper says 3)
• maximum score: 10
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Total Score
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Risk Group
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Stone-Free
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5 or 6
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low
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92%
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7 or 8
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middle
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78%
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9 or 10
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high
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8%
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Performance:
• The area under the ROC curve is 0.93.
