External validation of the STONE score in patient with acute flank pain in Emergency department of Ramathibodi Hospital.
Category:
Background:
Acute flank pain is common chief complain in patient who visit emergency room. Most of them were diagnosed urolithiasis without diagnostic imaging because of limitation of CT scan availability. The STONE score is a clinical decision rule was recently derived for selecting appropriate flank pain patients for CT scan.
Objective:
Aim of this study is to explore performance of the STONE score in acute flank pain patients in ER Ramathibodi hospital.
Method:
Cross sectional study was conducted in acute flank pain patients who visited ER Ramathibodi hospital between August 2014 and September 2015. Medical record, laboratory result and diagnostic imaging were reviewed.
Results:
Two hundred forty-three participants were enrolled, of which 145 (59.67%) were ureteral stone. Ninety four (64.83%) were male and 51(35.17%) were females. Mean age was 47 years old. All factors of STONE score were significantly related to ureteral stone, except nausea. The prevalence of ureteral stone in the low, moderate, and high-score groups of original STONE score were 22.73, 58.02 and 86.76 respectively. There were good calibration performance of original STONE score, Deleted nausea score and Modified stone score (p=0.11, p=0.69 and p=0.36). AUC of ROC of original STONE score, Deleted nausea score, Modified stone score were 0.778 (95% CI: 0.73, 0.84), 0.785 (95% CI: 0.72, 0.84), 0.817 (95% CI: 0.76, 0.87) respectively.
Conclusion:
STONE score is moderate effective tool to use to predict ureteral stone in acute flank pain patient in Ramathibodi hospital where as Modified stone score is more effective than Original STONE score in predict ureteral stone.