A prospective study to determine if serum C - C-reactive protein is an effective predictive tool for early surgical intervention in patients with <10 mm ureteric stones

ABSTRACT Background: Urolithiasis is a worldwide problem traversing all topographical areas with a projected annual incidence of 1%, prevalence of 3%–5%, and a lifetime risk of 15%–25%. Once affected, urolithiasis inclines to be recurring in the majority of cases. Inflammatory responses from urethral stone obstruction may upsurge serum C-reactive protein (CRP) levels, and incidental identification of the degree of inflammation may be used to forecast the spontaneous passage rate and thus may be supportive in treatment selection. We aimed for a predictive factor for early surgical intervention to avoid a waiting period for spontaneous stone passage in patients with high CRP. Methods: All patients presenting with <10 mm ureteric stone attending/diagnosed general surgery department in a tertiary care institute. When a categorical variable is associated with a quantitative variable, the variables are represented in both tables and bar diagrams. For the test of significance, an unpaired t -test is used. P < 0.05 were considered statistically significant. Results: In the spontaneous stone-passed (SSP) group, the mean size of the stone was 6.00 + 0.63 and in the non-SSP group was 7.63 + 0.78. The range of stone size was 5–7 mm in the SSP group and 6–9 in the non-SSP group. In the SSP group, 57.1% of stones were on the right side, and in the non-SSP group, 51.5% of stones were on the right side. Receiver operating characteristic analysis resulted in an area under the curve of 0.986 ( P < 0.001) for serum CRP level. The cutoff value for serum CRP level provided by Youden’s index analysis was 10 mg/l for CRP yielded appeared optimal for the prediction of spontaneous ureteric stone expulsion with a sensitivity of 100%, a specificity of 95.2%. Conclusions: We conclude that the determination of CRP in patients with renal colic due to the ureteral stone has proven to be more useful than other conventional markers in the decision for the need for urgent surgical intervention.