Clinical Application And Comparison Of RUSS Score, Modified S-ReSC Score, RIRS Score And TOHO. Scoring System In Predicting The Stone Clearance Rate After Flexible Ureteroscopy

Objective: To analyze the risk factors that affect the stone clearance rate after RIRS by statistical methods,and to evaluate and compare the predictive value of the four scores in predicting the stone clearance rate after RIRS.Methods: A retrospective analysis of the medical records of 150 patients with kidney stones who received RIRS from September 2018 to March 2020 in our hospital.Record demographic data and kidney stone characteristic data of each patient,use statistical methods to study the relationship between various factors and stone residuals,use receiver operating characteristic curve(ROC)analysis and compare the prediction of stone residuals by each scoring model value.Results: In the one-month follow-up examination,108 patients(72.00%)achieved stone-free status,and 42 patients had one or more residual masses(28.00%).Regardless of whether the RIRS reached a stone-free state,the differences in the stone characteristics of the patients such as RIPA,RIL,lower calculus,kidney stone density,and stone load were statistically significant(p<0.001,p: 0.003,p <0.001,p<0.001,p< 0.001).Binary logistic regression analysis showed that RIPA,RIL,lower calyx stones,kidney stone density and stone load are also independent risk factors that affect stone removal.Four scoring systems can predict postoperative stone clearance rate.The areas under the ROC curve were 0.706(RUSS score),0.666(modified S-Re SC score),0.742(R.I.R.S.score),and 0.682(T.O.HO.score).Conclusion: RIPA,RIL,lower calyx stones,kidney stone density and stone load are independent risk factors that affect stone clearance.The four scoring systems can predict the stone clearance rate after RIRS.In this study,the RIRS scoring system is highly accurate for the other three scoring systems.