A Comparative Evaluation of the Predictive Accuracy, Clinical Utility, and Application Efficiency of Four Nephrolithometric Nomograms for Percutaneous Nephrolithotomy Outcomes

OpenAlex İngilizce

OBJECTIVE: To evaluate the predictive roles of four commonly used nephrolithometric nomograms-Guy's Stone Score (GSS), Stone size, Tract length (skin-to-stone distance), degree of Obstruction, Number of involved calyces, and Essence (stone density) (S.T.O.N.E), Clinical Research Office of the Endourological Society (CROES), and Seoul National University Renal Stone Complexity Score (S-ReSC)-for predicting stone-free status (SFS), postoperative complications, operative time (OT), and length of hospitalisation (LH) following percutaneous nephrolithotomy (PCNL), and to compare their application times. STUDY DESIGN: An analytical study. Place and Duration of the Study: Department of Urology, Medical Faculty, Adnan Menderes University, Aydin, Turkiye, from December 2022 to February 2024. METHODOLOGY: Medical records of 50 patients who underwent PCNL were analysed retrospectively. A single observer scored each nomogram, and the time required for calculation was recorded. Statistical analyses included logistic and linear regression, chi-square test, and receiver operating characteristic (ROC) analysis to assess each nomogram's predictive effectiveness for SFS, complications, OT, and LH. RESULTS: The mean age of the cohort was 50.96 ± 14.49 years, and 60% were men. Nomogram application times varied significantly, with GSS and S-ReSC both taking under 30 seconds. The S-ReSC and CROES nomograms effectively predicted complications, while all four were associated with SFS and OT. ROC analysis revealed similar areas under the curve for predicting SFS among the four nomograms. CONCLUSION: GSS and S-ReSC, which are the quickest to apply and have predictive power for SFS comparable to that of the other nomograms, stand out as the preferred options in appropriate clinical settings. KEY WORDS: Percutaneous nephrolithotomy, Nephrolithometric nomograms, Stone-free status, Predictive accuracy, Guy's Stone Score, S.T.O.N.E [Stone size, Tract length (skin-to-stone distance), degree of Obstruction, Number of involved calyces, and Essence (stone density)], Clinical Research Office of the Endourological Society, and Seoul National University Renal Stone Complexity Score.