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Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort
OBJECTIVES: The objectives of this study are to determine the predictors of success following extracorporeal shock-wave lithotripsy (ESWL) in a contemporary cohort at a high-volume stone center. METHODS: We conducted a retrospective review all patients who underwent an elective ESWL within our insti...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343291/ https://www.ncbi.nlm.nih.gov/pubmed/34421266 http://dx.doi.org/10.4103/UA.UA_155_19 |
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author | Bajaj, Mohit Smith, Russell Rice, Michael Zargar-Shoshtari, Kamran |
author_facet | Bajaj, Mohit Smith, Russell Rice, Michael Zargar-Shoshtari, Kamran |
author_sort | Bajaj, Mohit |
collection | PubMed |
description | OBJECTIVES: The objectives of this study are to determine the predictors of success following extracorporeal shock-wave lithotripsy (ESWL) in a contemporary cohort at a high-volume stone center. METHODS: We conducted a retrospective review all patients who underwent an elective ESWL within our institution over a 24-month period (January 2014 to December 2015). Data on patient demographics, stone variables, and inpatient treatment outcomes were evaluated. The presence of residual stone fragments larger than 4 mm on follow-up imaging was considered to be treatment failure. Using this threshold, clinically relevant variables between the treatment success and failure groups were identified. Multivariable logistic regression analyses (MVA) of clinically relevant variables were used to determine the independent factors predicting ESWL success. RESULTS: Of 446 study eligible patients, 421 patients had complete follow-up data and were included in the analysis. Treatment was successful in 72.2% of patients in this study. Stone size, number of shocks delivered, and maximum treatment intensity were statistically different in the two groups. In a MVA where stone size, location, density, presence of ureteric stent, skin-stone distance (SSD), number of shocks, and maximum shock intensity were included, only stone size of <10 mm (odds ratio [OR] 3.4 [95% confidence interval [CI]: 1.98–5.84]) and SSD <15 cm (OR: 0.133, [95% CI: 0.027–0.65]) were the independent predictor of ESWL success. CONCLUSION: We have demonstrated “real world” outcomes with high-volume use of ESWL. In our experience that with diligent patient selection, ESWL remains an effective tool for the management of upper tract calculi. |
format | Online Article Text |
id | pubmed-8343291 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-83432912021-08-20 Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort Bajaj, Mohit Smith, Russell Rice, Michael Zargar-Shoshtari, Kamran Urol Ann Original Article OBJECTIVES: The objectives of this study are to determine the predictors of success following extracorporeal shock-wave lithotripsy (ESWL) in a contemporary cohort at a high-volume stone center. METHODS: We conducted a retrospective review all patients who underwent an elective ESWL within our institution over a 24-month period (January 2014 to December 2015). Data on patient demographics, stone variables, and inpatient treatment outcomes were evaluated. The presence of residual stone fragments larger than 4 mm on follow-up imaging was considered to be treatment failure. Using this threshold, clinically relevant variables between the treatment success and failure groups were identified. Multivariable logistic regression analyses (MVA) of clinically relevant variables were used to determine the independent factors predicting ESWL success. RESULTS: Of 446 study eligible patients, 421 patients had complete follow-up data and were included in the analysis. Treatment was successful in 72.2% of patients in this study. Stone size, number of shocks delivered, and maximum treatment intensity were statistically different in the two groups. In a MVA where stone size, location, density, presence of ureteric stent, skin-stone distance (SSD), number of shocks, and maximum shock intensity were included, only stone size of <10 mm (odds ratio [OR] 3.4 [95% confidence interval [CI]: 1.98–5.84]) and SSD <15 cm (OR: 0.133, [95% CI: 0.027–0.65]) were the independent predictor of ESWL success. CONCLUSION: We have demonstrated “real world” outcomes with high-volume use of ESWL. In our experience that with diligent patient selection, ESWL remains an effective tool for the management of upper tract calculi. Wolters Kluwer - Medknow 2021 2021-07-14 /pmc/articles/PMC8343291/ /pubmed/34421266 http://dx.doi.org/10.4103/UA.UA_155_19 Text en Copyright: © 2021 Urology Annals https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Bajaj, Mohit Smith, Russell Rice, Michael Zargar-Shoshtari, Kamran Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title | Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title_full | Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title_fullStr | Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title_full_unstemmed | Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title_short | Predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
title_sort | predictors of success following extracorporeal shock-wave lithotripsy in a contemporary cohort |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343291/ https://www.ncbi.nlm.nih.gov/pubmed/34421266 http://dx.doi.org/10.4103/UA.UA_155_19 |
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