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A data-driven revision of the S.T.O.N.E. nephrolithometry score: Improved predictive accuracy for stone-free status after PCNL.
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6 authors.
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Abstract
ObjectiveTo improve the S.T.O.N.E. nephrolithometry scoring system by applying a factor weighting method derived from odds ratios (ORs) in logistic regression analysis for a more scientific prediction of stone-free rate (SFR) after percutaneous nephrolithotomy (PCNL).MethodsWe conducted a retrospective cohort study of 283 patients undergoing PCNL. The SFR was the primary outcome. Binary logistic regression identified independent predictors among the S.T.O.N.E. components. Statistically significant factors were assigned weighted points based on their ORs. The improved system's performance was compared to the traditional S.T.O.N.E. score using receiver operating characteristic analysis, Net Reclassification Improvement (NRI), and risk stratification based on Youden index-optimized cutoffs.ResultsStone size, obstruction, and stone density were independent predictors of SFR (all
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