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Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach

 Kang Su Cho  ;  Hae Do Jung  ;  Won Sik Ham  ;  Doo Yong Chung  ;  Yong Jin Kang  ;  Won Sik Jang  ;  Jong Kyou Kwon  ;  Young Deuk Choi  ;  Joo Yong Lee 
 PLOS ONE, Vol.10(12) : e0144912, 2015 
Journal Title
Issue Date
Adult ; Age Factors ; Aged ; Bayes Theorem ; Cohort Studies ; Female ; Humans ; Kidney Calculi/diagnostic imaging ; Kidney Calculi/therapy* ; Lithotripsy* ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Sex Factors ; Skin/diagnostic imaging* ; Tomography, X-Ray Computed
OBJECTIVES: To investigate whether skin-to-stone distance (SSD), which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL) in patients with upper ureter stones.

PATIENTS AND METHODS: We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4-20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU), and SSD were determined on pretreatment non-contrast computed tomography (NCCT). For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile.

RESULTS: In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032). The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL.

CONCLUSIONS: Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL.
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Appears in Collections:
6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yong Jin(강용진)
Kwon, Jong Kyou(권종규)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Jang, Won Sik(장원식) ORCID logo https://orcid.org/0000-0002-9082-0381
Chung, Doo Yong(정두용)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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