کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3898876 1250310 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
External Validation of a Preoperative Renal Stone Grading System: Reproducibility and Inter-rater Concordance of the Guy's Stone Score Using Preoperative Computed Tomography and Rigorous Postoperative Stone-free Criteria
ترجمه فارسی عنوان
اعتبار خارجی یک سیستم درجه بندی سنگ کلیه قبل از عمل: بازتوزیع پذیری و هماهنگی بین اهداف سنگ گای با استفاده از توموگرافی کامپیوتری قبل از عمل و معیارهای سنگین بدون محدودیت بعد از عمل
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
چکیده انگلیسی

ObjectiveTo validate the Guy's stone score (GSS) using preoperative computed tomography (CT) and to assess its inter-rater concordance and association with rigorous definitions of stone clearance.MethodsThe preoperative CT scans of 166 consecutive percutaneous nephrolithotomy (PCNL) patients treated by a single surgeon were independently reviewed by 2 urology residents and graded according to GSS. Concordance was calculated using Cohen's kappa score. Residual fragments (RFs) were evaluated on CT or plain radiography on postoperative day 1. GSS was correlated with 3 different outcomes; RFs <4 mm, RFs <2 mm, or no RFs.ResultsHigher GSS was associated with decreased stone clearance by any metric on a CT scan: RFs <4 mm (P = .03), RFs <2 mm (P = .02), or no RFs (P = .02). On plain radiography, higher GSS was only associated with lower likelihood of no RFs (P <.005). Inter-rater concordance was good (κ = 0.72), with 78% of cases categorized the same by both raters. Twelve of 36 cases (33%) of disagreement were between categories II and III and 20 of 36 cases (56%) pertained to unclear definitions of “partial staghorn stone” and “abnormal anatomy.”ConclusionThe GSS is a straightforward grading system of the complexity of renal stones. When applied to preoperative CT scans, it offers good inter-rater concordance and is associated with rigorous endpoints of stone clearance. The inter-rater concordance could be further improved by explicit definitions of abnormal anatomy, partial vs complete staghorn stones, and the size of a calculus that constitutes a separate stone.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Urology - Volume 83, Issue 1, January 2014, Pages 45–49
نویسندگان
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