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% |
Specialty: Nephrology, Clinical Laboratory
ICD-10: ,