Mp70-05 association between the hydronephrosis outcome prediction score and obstruction on mag-3

You have accessJournal of UrologyCME1 Apr 2023MP70-05 ASSOCIATION BETWEEN THE HYDRONEPHROSIS OUTCOME PREDICTION SCORE AND OBSTRUCTION ON MAG-3 Carol Davis-Dao, Sarah Williamson, Rebecca Zee, Shannon Cannon, Luis Braga, Timothy Boswell, Kai-Wen Chuang, Melissa Mcgrath, Nora Kern, Gina Lockwood, Anne Dudley, Heidi Stephany, Elias Wehbi, Valre Welch, Antoine Khoury, and C.D. Anthony Herndon Carol Davis-DaoCarol Davis-Dao More articles by this author , Sarah WilliamsonSarah Williamson More articles by this author , Rebecca ZeeRebecca Zee More articles by this author , Shannon CannonShannon Cannon More articles by this author , Luis BragaLuis Braga More articles by this author , Timothy BoswellTimothy Boswell More articles by this author , Kai-Wen ChuangKai-Wen Chuang More articles by this author , Melissa McgrathMelissa Mcgrath More articles by this author , Nora KernNora Kern More articles by this author , Gina LockwoodGina Lockwood More articles by this author , Anne DudleyAnne Dudley More articles by this author , Heidi StephanyHeidi Stephany More articles by this author , Elias WehbiElias Wehbi More articles by this author , Valre WelchValre Welch More articles by this author , Antoine KhouryAntoine Khoury More articles by this author , and C.D. Anthony HerndonC.D. Anthony Herndon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003338.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For patients with isolated hydronephrosis and suspected ureteropelvic junction obstruction, diuretic renal scan (MAG-3) is one tool used for determining which patients may be obstructed. We sought to evaluate the Hydronephrosis Outcome Prediction (HOP) Score, which utilizes ultrasound measurements, for its association with obstruction based on MAG-3. METHODS: Patients with prenatally detected and postnatally confirmed isolated hydronephrosis were prospectively enrolled from 7 centers from 2007-2022. Baseline ultrasounds were included if performed between 3 days to 6 months of life and with SFU grade, anterior posterior renal pelvis diameter (APD) and renal lengths available for analysis. Exclusion criteria were vesicoureteral reflux, primary megaureter, other urologic anomalies, and follow-up <3 months. The HOP score, adapted from Li et al,1 utilizes 3 ultrasound parameters: SFU grade, APD, and absolute percentage difference of renal lengths. HOP score was calculated on a 12-point scale with each parameter assigned a score from 0-4, 0 being least severe and 4 being most severe. Obstruction on MAG-3 was defined as T half-time ≥20 minutes and function<40%. Area under the curve and logistic regression were determined for association between HOP scores and MAG-3 results. RESULTS: Of 1983 patients enrolled, 180 met inclusion criteria. Median HOP score was 8.0 (IQR 6-10) and median follow-up time was 34 months (IQR 22-48). Among the 19 (11%) patients with obstruction on MAG-3, the median HOP score was 9.0, while the remaining 161 patients had median HOP score of 8.0. HOP score≥9 was the optimum threshold for predicting obstruction with AUC 0.67 (95% CI: 0.55-0.77). On logistic regression, patients with HOP score≥9 at initial ultrasound were significantly more likely to have obstruction on MAG-3 (OR=3.8, 95% CI: 1.3-11, p=0.01). Overall, 92 (51%) of patients underwent pyeloplasty, while 25 (11%) resolved and 63 (35%) were under continued follow-up. CONCLUSIONS: We found that patients with HOP scores≥9 on initial ultrasound were more likely to show obstruction on subsequent MAG-3. In combination with our previous study that showed HOP scores≤4 are correlated with resolution, the HOP score is an accessible tool that predicts the outcomes of hydronephrosis from the initial postnatal ultrasound. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1004 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carol Davis-Dao More articles by this author Sarah Williamson More articles by this author Rebecca Zee More articles by this author Shannon Cannon More articles by this author Luis Braga More articles by this author Timothy Boswell More articles by this author Kai-Wen Chuang More articles by this author Melissa Mcgrath More articles by this author Nora Kern More articles by this author Gina Lockwood More articles by this author Anne Dudley More articles by this author Heidi Stephany More articles by this author Elias Wehbi More articles by this author Valre Welch More articles by this author Antoine Khoury More articles by this author C.D. Anthony Herndon More articles by this author Expand All Advertisement PDF downloadLoading ...