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J Korean Soc Emerg Med > Volume 29(2); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(2): 197-203.
STONE 점수는 요로 결석 의심 환자에서 전산화단층촬영 검사를 제한하는데 사용될 수 있을까? - 단일 기관 후향적 연구
이동근, 김형빈, 조영모 , 배병관, 왕일재 , 염석란 , 박성욱
부산대학교 의과대학 응급의학교실
Is STONE score a useful tool for limiting the use computed tomography in the patients suspected ureter stone? - A single-center retrospective study
Dong Geun Lee, Hyung Bin Kim, Young Mo Cho , Byung Kwan Bae, Il Jae Wang , Seok Ran Yeom , Sung Wook Park
Department of Emergency Medicine, Pusan National University College of Medicine, Busan, Korea
Correspondence  Sung Wook Park ,Tel: 051-240-7503, Fax: 051-253-6472, Email: psu52156@naver.com,
Received: December 17, 2017; Revised: February 19, 2018   Accepted: March 1, 2018.  Published online: April 30, 2018.
ABSTRACT
Objective:
The STONE score was developed to gauge the ureter stone probability. On the other hand, it is unclear if the STONE score is also applicable to Koreans. This study evaluated whether the STONE score can identify patients with suspected nephrolithiasis for whom a computed tomography (CT) scan can be obtained in the emergency department, targeting Koreans.
Method:
Patients presenting to the emergency medicine (ED) with flank pain and a suspicion of a ureter stone between January 2016 and December 2016 were reviewed retrospectively. After calculating the STONE score, the enrolled patients were classified into the low, moderate, high score group. In each group, the prevalence of a ureter stone and other clinical diseases on a CT scan were investigated.
Results:
Among the 156 patients included in the analysis, 124 (79.5%) had a ureter stone and an alternative diagnosis was made in 12 (7.7%). The prevalence of a ureter stone and alternative diseases in the high score group was 87.7% (71/81) and 4.9% (4/81), respectively. The proportion of patients with nephrolithiasis increased significantly (P<0.001), but the proportion of patients with other clinical diseases did not decrease significantly across the score groups (P=0.196). The area under the receiver operating characteristic curve was 0.711 (95% confidence interval, 0.633-0.780; P=0.001) with a cut off score higher than 8 (sensitivity 82.3%, specificity 50.0%) for the STONE score.
Conclusion:
In this setting, the STONE score had a low specificity and could not accurately assess a ureter stone. More studies aimed at Koreans are warranted before a CT scan can be limited using the STONE score.
Key words: Ureteral calculi; Tomography; Diagnosis; Sensitivity and specificity
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