Role of the systemic immune-inflammation index in predicting spontaneous stone passage in patients with renal colic

ABSTRACT

Objectives

Renal colic (RC) is one of the most frequent reasons for presentation to the emergency department (ED) and creates a high economic and medical burden. Management strategies for RC range from waiting for spontaneous passage to surgical intervention. However, factors determining spontaneous stone passage (SSP) are still poorly understood. Therefore, in this study, we aimed to investigate the role of the systemic immune-inflammatory index (SII) in predicting SSP.

Methods

We retrospectively analyzed the data of 924 patients aged over 18 years, who were diagnosed with RC in our clinic between 1 January 2019, and 30 May 2022, and had ureteral stones of ≤ 10 mm. The patients were divided into two groups according to whether they had SSP. The clinical and laboratory characteristics of the patients in the ED were evaluated. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) values of the patients were calculated. Stone size and location were also recorded.

Results

In the univariate analysis of SSP, a ureteral stone size of ≤ 5 mm (p < 0.001), distal ureteral location (p < 0.001), SII (p < 0.001), NLR (p < 0.001), and PLR (p = 0.036) were significantly correlated with SSP. ROC analysis showed that an SII level < 721.8 (Sensitivity %82.6, Specificity %74.7, p < 0.001) was an independent predictor of SSP.

Conclusion

Our findings showed that a low SII level was associated with SSP and could be used as a predictive marker of SSP as a more valuable parameter than NLR. SII and NLR, together with other indicators, are inflammatory markers that can be used in the clinical decision-making process for ureteral stone treatment.

KEYWORDS:

• Spontaneous stone passage
• systemic immune-inflammation index
• renal colic
• predicting
• emergency department

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. A reviewer on this manuscript has disclosed being a tutor, consultant, speaker and live surgeon for Boston Scientific, Coloplast Porgés, EMS, Karl Storz, Olympus, Quanta System and Teleflex. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Acknowledgments

The authors would like to thank the patients and their families and the staff of the health central.

Author contributions

H Mutlu, AN Kankılıc conceptualized and designed the study, drafted the initial manuscript, and reviewed, and revised the manuscript. H Mutlu, AN Kankılıc, ET Sert, K Kokulu designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript. H Mutlu, AN Kankılıc, ET Sert, K Kokulu conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Ethics statement

This study was approved by local Ethics Committee of Aksaray University Faculty of Medicine (number: E-2022-12/2). The Ethics Committee waived the requirement for informed consent due to the retrospective observational nature of the study.

Data availability statement

All relevant data are included in the article. Further inquiries can be directed to the corresponding authors.

Additional information

Funding

This paper was not funded.