Nomogram of Sugihara et al for Predicting Severe Adverse Events After Ureteroscopic Lithotripsy

Description

Sugihara et al developed a nomogram for predicting severe adverse events following ureteroscopic lithotripsy. These can help to identify a patient who may require more careful planning before lithotripsy or an alternative therapy. The authors are from Shintoshi Hospital, the University of Tokyo, Tokyo Medical and Dental University, and the University of Occupational and Environmental Health in Fukuoka, Japan.

Patient selection: Japanese patient undergoing ureteroscopic lithotripsy

Severe adverse events: death, postoperative invasive intervention, postoperative medication including transfusion or treatment of DIC

Parameters:

(1) age

(2) gender

(3) Charlson comorbidity index

(4) type of anesethesia

(5) operation time in minutes

(6) hospital volume (for lithotripsy)

(7) type of admission

Parameter	Finding	Points
age in years	<= 59 years	0
	60 to 69 years	19
	70 to 79 years	20.5
	>= 80 years	51.3
gender	male	0
	female	24.1
Charlson comorbidity index	0	0
	1	20.5
	2	39.9
	>=3	56.1
type of anesthesia	spinal or epidural	0
	general	22.1
operation time	>= 59 minutes	0
	60 to 89 minutes	26.1
	90 to 119 minutes	31.2
	120 to 149 minutes	55.3
	150 to 179 minutes	60
	180 to 209 minutes	73.1
	>= 210 minutes	100
hospital volume	>= 39	0
	16 to 38	14.6
	<= 15	30.8
type of admission	elective	0
	emergency without ambulance transfer	39.9
	emergency with ambulance transfer	70.3

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 354.7 (maximum score reportedly seen < 300)

• The higher the score the greater the risk of a serious adverse event.

Total Score	Percent with Serious Adverse Event
< 42.7	< 1%
42.7 to 156.4	(0.000235 * ((score)^2)) - (0.01169 * (score)) + 1.079
156.4 to 263.5	(0.1349 * (score)) - 16.38
> 263.5	> 20%

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Description

Specialty

ICD-10