📃 Paper Title: Factors associated with the spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic: results from the Multi-centre cohort study evaluating the role of inflammatory markers In patients presenting with ureteric Colic (MIMIC) study
🧍 Author: Taimur Shah
🕒 Year: 2019
📚 Journal: BJU International
🌎 Country: UK
ㅤContext to the study:
Can you tell me about a recent study that assess the factors associated with spontaneous stone passage in patients presenting with acute ureteric colic?
ㅤ✅ Take-home message of study:
Overall rate of spontaneous stone passage (SSP) for conservative management of all ureteric stones = 74%
Larger stone size and proximal position were independently associated with failed SSP
ㅤ Multicentre retrospective cohort study
ㅤ
Study participants:
All participants = 4,170 (71 hospitals, four countries)
Total participants with decision for conservative management and outcome data at follow-up of 6 months = 2,518
Inclusion criteria:
CT confirmed solitary ureteric stone
ㅤ
ㅤ
Key study outcomes:
Conservative management and outcome data available (n=2518)
Overall spontaneous stone passage (SSP) (no surgical intervention required to assist with stone passage) = 74%
SSP for <5mm = 89%
SSP for 5 to 7mm = 49%
SSP for >7mm = 29%
Risk of sepsis with conservative management = 0.6%
Multivariate model (logistic regression):
Factors significantly associated with failed SSP:
Stone size 5-7mm (OR 0.18)
Stone size >7mm (OR 0.08)
Upper ureteric position (OR 0.25)
No association between SSP and following factors:
White cell count (WCC); C reactive protein (CRP); Age; Gender, Presence of Hydronephrosis; MET
ㅤ
ㅤ
Study Limitations:
Not all participants had CT confirmation of spontaneous stone passage at follow-up
Approximately 20% of patients on conservative management lost to follow-up
ㅤ