Mp72-10 the Hydronephrosis Early Risk of Obstruction (Hero) Score: An Attempt to Forecast Upjo-Like Suggestive of Obstruction

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-10 THE HYDRONEPHROSIS EARLY RISK OF OBSTRUCTION (HERO) SCORE: AN ATTEMPT TO FORECAST UPJO-LIKE SUGGESTIVE OF OBSTRUCTION Roseanne Ferreira, Melissa McGrath, and Luis H. Braga Roseanne FerreiraRoseanne Ferreira , Melissa McGrathMelissa McGrath , and Luis H. BragaLuis H. Braga View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This study aims to determine the utility of the Hydronephrosis Early Risk of Obstruction (HERO) score in identifying severe UPJO-like hydronephrosis suggestive of obstruction. METHODS: A prenatal HN database (2008-23) was reviewed to select patients with unilateral UPJO-like HN. Those with VUR, megaureter, atrophy and bilateral disease were excluded. SFU, APD and renal length index (RLI) were captured from the baseline ultrasound. Obstruction was defined as a t ½ time >30 minutes and/or a plateau/ascending drainage curve on MAG 3 Lasix renal scan. Multivariable logistic regression, C-statistics and Calibration-plots were used to identify models performance. RESULTS: Of the 465 patients, 226(49%) were SFU 3-4, 162 (35%) were obstructed on MAG 3 and 129 (28%) had pyeloplasty. Median age at baseline was 2.8 months(IQR 1.4-4.8). The HERO score accurately identified patients with obstruction (AUC 0.93) (Figure 1) and those undergoing surgery (AUC 0.94) (Figure 2). A risk score for obstruction was created attributing points to the HERO model based on regression (Table 1). Only 12% underwent pyeloplasty with a HERO score 4 vs 90% with a HERO score >7% (p<0.001). CONCLUSIONS: A risk score for obstruction in infants <12 months with prenatal UPJO-like hydronephrosis is useful and accurate in segregating patients who can be monitored non-surgically from those with more severe obstruction that may benefit from pyeloplasty. 90% of patients with a HERO score >7 have severe UPJO that merits surgical correction. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1175 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roseanne Ferreira More articles by this author Melissa McGrath More articles by this author Luis H. Braga More articles by this author Expand All Advertisement PDF downloadLoading ...