Can the stone scoring systems be used to predict infective complications
of retrograde intrarenal surgery?
Abstract
Aim: In this study, we aimed to evaluate the association between
infective complications after retrograde intrarenal surgery (RIRS) and
RIRS scoring systems includes the Resorlu-Unsal Stone Score (RUSS),
Modified Seoul National University renal stone complexity score
(modified S-ReCS) and R.I.R.S score. Methods: Patients with renal
calculi detected on imaging, who underwent RIRS in the urology clinic of
a tertiary hospital between January 2013 and May 2020 were included in
the study. A total of 581 patients who underwent RIRS for the kidney
stones detected with imaging methods were included in the study. The
RUSS and modified S-ReCS and R.I.R.S. scores of the patients were
determined. Results: Infective complications were detected in 47 (8.1%)
patients who underwent RIRS. There were fever in 27 (4.6%), urinary
infection in 15 (2.5%), sepsis in 2 (0.3%) and septic shock in 3
(0.5%) patients. In multivariate logistic regression analysis, age (OR:
1.8; 95% CI: 1-3.4; p:0.049), surgical duration of >60
minutes (OR: 1.9; 95% Cl: 1.1–3.5; p:0.027) RIRS score (OR: 8.9; 95%
CI: 1.9-42.4; p:0.006) have been shown to be independent risk factors
for the development of infective complications. A ROC curve analysis
showed that the R.I.R.S scoring system can be used as a marker to
predict infective complications. (Area under the curve (AUC):0.619, CI:
0.55–0.69; p:0.007) The cut-off point for the R.I.R.S scoring system
was found to be 5.5 points using Youden’s test. Conclusion: In our
study, we showed that the R.I.R.S scoring system can be used to predict
infective complications in RIRS.