Comparison of Guy's, STONE and CROES Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes in Eldery Patients

Abstract

Objective: To evaluate the efficacy and reliability of Guy's (GSS), S.T.O.N.E., and CROES scoring systems developed to predict percutaneous nephrolithotomy (PCNL) outcomes in aged patients. Study Design: Descriptive study. Place and Duration of Study: Department of Urology, Ministry of Health University Izmir Bozyaka Training and Research Hospital and Department of Urology, Faculty of Medicine, Amasya University, Turkey, from April 2011 to January 2020. Methodology: Patients aged 65 years and over, who underwent PCNL for kidney stones, were retrospectively analysed. The patients' clinical and perioperative characteristics and the radiological features of the stones were obtained from the prospectively recorded data. GSS, S.T.O.N.E. and CROES nephrolithometry scores were calculated for each patient and their relation with stone-free status, complications, and perioperative findings were analysed. Results: A total of 147 patients were included in the study. Stone-free status was achieved in 76.0% of the patients, and complications developed in 27.2%. All three scoring systems were associated with stone-free status and complication development. GSS (OR=0.213,p=0.005) and S.T.O. N.E. (OR=0.601, p=0.042) scores were detected as independent markers for stone-free status, while the CROES score was not an independent marker. Only diabetes mellitus was determined to be an independent marker for the development of complications (OR=2.375, p=0.045). Conclusion: PCNL is an effective and safe treatment method with high stone-free rates in the treatment of large renal stones, but care should be taken in terms of cardiac risks. The results of this study showed that GSS and S.T.O.N.E. scoring systems were effective and reliable in predicting stone-free status.