ORIGINAL ARTICLE

Validity S.T.O.N.E. nephrolithometry scoring to predict stone free status in kidney stone patients after percutaneous nephrolithotomy

Anak Agung Gde Oka , Anak Agung Ayu Oka Kusuma Dewi, I Gede Raka Widiana

Anak Agung Gde Oka
Urology Surgeon. Division of Urology, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali-Indonesia. Email: [email protected]

Anak Agung Ayu Oka Kusuma Dewi
General Surgery Resident, Departement of Surgery, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali-Indonesia

I Gede Raka Widiana
Departement of Internal Medicine, Faculty of Medicine Udayana University/Sanglah General Hospital, Bali-Indonesia
Online First: April 01, 2020 | Cite this Article
Oka, A., Dewi, A., Widiana, I. 2020. Validity S.T.O.N.E. nephrolithometry scoring to predict stone free status in kidney stone patients after percutaneous nephrolithotomy. Bali Medical Journal 9(1): 155-162. DOI:10.15562/bmj.v9i1.1719


Background: Kidney stone still a health problem in the world. Today, the choice of therapeutic modality is also increasingly varied, percutaneous nephrolitotomy (PCNL) is still the first line for stone therapy with varying success rates, some high or low. Sometimes need additional measures such as extracorporeal shock wave lithotripsy (ESWL), retrograde intrarenal surgery (RIRS) for the rest stone and good preventive behaviour are needed. This can be influenced by several risk factors, a risk factor predictor is required to get a high stone free rate in patients after PCNL.

Methods: This research is a cross sectional retrospective study, we recorded 50 patients at the Medical Records Installation at Sanglah Education General Hospital in Denpasar since January 2018-November 2019 with kidney stones performed by PCNL, each patient will be calculated S.T.O.N.E Nephrolithometry score can be seen on CT Stonography and the presence or absence of stone after PCNL. The parameters of S.T.O.N.E Nephrolithometry are size, tract obstruction, number of calyces, essence. And calculated the best cut off, sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of the S.T.O.N.E Nephrolithometry score to predict stone free status after PCNL.

Results: The best cut off value in this study is <9, where patients with S.T.O.N.E Nephrolithometry score  < 9 have a risk stone free after PCNL 25 (50%) patients, while the S.T.O.N.E Nephrolithometry score >9, has a risk of not being free and there are stones left  25 (50%) patients. S.T.O.N.E Nephrolithometry had % sensitivity 60.6%, specificity 70.6%, and 64 % accuracy in this study. Positive predictive value and negative predictive values were 80% and 48%.

Conclusion: from this study the S.T.O.N.E Nephrolithometry score sensitively predicts stone free status in kidney stone patients after PCNL and can be used as a tool to education the patient before PCNL and therapy.

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